Abstract
Blood stream infections associated with central venous catheterization are usually caused by the biofilm formed on the surface of the indwelling catheter, although the precise mechanisms are not fully understood. This study examined catheters from 12 seriously ill patients who had underlying persistent fever of over 38°C. Scanning electron microscopy revealed that 5 catheters were coated with biofilm on the surface. The biofilm was generally formed on the outside but not the inside of the catheter. Numerous bacterial cells as well as blood cells were embedded in the biofilm matrix. The fever of these patients resolved after removal of the catheters, suggesting that the fever was caused by the biofilm on the catheter. Interestingly, 4 of the 5 patients had negative blood culture and culture of the catheter tip. Candida albicans was isolated from the blood culture and the culture of catheter in one patient, and biofilm containing Candida-like cells was observed on the surface of the inside as well as the outside of the catheter. The present study confirmed that the persistent fever of patients with negative bacteriological examinations was caused by the biofilm on the catheter.
