A novel model of epidural catheter-related infection: the importance of repeated catheter movements

抄録

Staphylococcus spp., which are nonmotile, are the most frequently isolated pathogens from the catheter of epidural abscesses. The movement mechanisms of Staphylococci remain unclear. We hypothesized that increased bacterial concentration and catheter reciprocal movements correlated with deeper penetration of Staphylococci into the catheterized site. We investigated the correlations among bacterial concentrations on the needle puncture surface and epidural catheter insertion sites, catheter movement, and Staphylococcus aureus growth in deeper layers of the agar. Staphylococci grew in the deeper layers of the agar when bacterial concentrations on the needle puncture surface and catheter insertion sites were increased. When 5-mm reciprocal movements of the catheter were repeated every 12 h over a 72-h period, Staphylococci penetrated the 5-cm-thick agar, the average distance from the skin to epidural space in adults. This resulted in increased Staphylococci concentrations and minor repeated catheter-movements because of physical movements of patients, which may result in the migration of Staphylococci into deeper tissues from the skin surface.