Ex vivo modeling of extraluminal migration of pathogenic microbes in the presence of a hemostatic agent

Abstract

BACKGROUND: Vascular access devices, such as central venous catheters are essential for managing the treatment needs of complex patients. However, these devices are susceptible to complications including infection and postinsertion bleeding. Therefore, this study aimed to evaluate the antimicrobial potential of the potassium ferrate hemostatic disc on common vascular access device related pathogens using an ex vivo model. METHODS: This study utilized an ex vivo skin model to evaluate the antimicrobial potential of the hydrophilic polymer and compressed potassium ferrate hemostatic disc for inhibiting extraluminal migration of gram-positive Staphylococcus aureus strains, gram-negative Pseudomonas aeruginosa and Klebsiella pneumoniae, and the yeast, Candida albicans. RESULTS: In the presence of anticoagulated blood, microbial growth was inhibited for some strains over 7days in culture in the presence of the hemostatic disc. Upon exposure to blood, the hemostatic disc generated an occlusive seal at the point of catheter entry into the skin, acting as a physical and chemical microbial control. The hemostatic disc was tested alongside chlorhexidine gluconate-impregnated disks and chlorhexidine gluconate-impregnated gel dressings. CONCLUSIONS: Our results indicate promising antimicrobial properties associated with the hemostatic disc against migration of commonly encountered vascular access device related pathogens.