Source: http://www.asmscience.org/content/book/10.1128/9781555818067.chap6
Timestamp: 2019-04-22 22:08:24+00:00

Document:
The pathogenesis of vascular catheter infections has recently been extensively reviewed. This chapter summarizes existing understandings and presents details of new work published on vascular catheter infections since the recent reviews. Many factors have been shown to affect the risk of catheters becoming infected. These include the unique abilities of certain organisms, Staphylococcus epidermidis, Staphylococcus aureus, and Candida albicans, to cause catheter-related infections. Molecular typing studies increasingly are improving our understanding of the pathogenesis of S. epidermidis/CoNS catheter-related infection. Recent studies with isogenic S. epidermidis mutants increasingly suggest that production of a polysaccharide adhesin is crucial to the pathogenesis of foreign-body infection. This polysaccharide, first named PS/A, was initially described as a virulence factor in association with work examining the pathogenesis of endocarditis. Two additional findings of relevance to the pathogenesis of endocarditis and possibly vascular catheter infections are that binding to platelets facilitates endocarditis and S. aureus strains causing endocarditis are much more likely to be resistant to platelet microbicidal proteins. The pathogenesis of catheter-related thrombosis has been studied in greater depth in recent years. With peripheral catheters, ultrasonographic imaging has shown that early thrombus formation (<24 h after insertion) occurs near the site of insertion, whereas later thrombus formation (>24 h after insertion) occurs near the catheter tip. Recent in vitro studies have shown that surface manipulations of polyurethane can lead to differences in protein and platelet deposition with associated differences in bacterial adherence.
Vascular catheter biofilm showing staphylococci in association with proteins and glycocalyx.
Quantitative relationship between the number of CFU of Staphylococcus aureus removed by sonication and gross purulence observed in a rabbit model of foreign-body infection. This is a new analysis of data from Sherertz et al. ( 74 ).
1. Aldazabal, P.,, I. Eizaguirre,, M. J. Barrena,, J. M. Garcia-Arenzana,, C. Ariz,, and E. Cuadrado. 1998. Bacterial translocation and T-lymphocyte populations in experimental short-bowel syndrome. Eur. J. Fed. Surg. 8: 247– 250.
2. Andris, D. A.,, E. A. Krzywda,, C. E. Edmiston,, C. J. Krepel,, and C. M. Gohr. 1998. Elimination of intraluminal colonization by antibiotic lock in silicone vascular catheters. Nutrition 14: 427– 442.
3. Bailly, A. L.,, A. Laurent,, H. Lu,, I. Elalami,, P. Jacob,, O. Mundler,, J. J. Merland,, A. Lautier,, J. Soria,, and C. Soria. 1996. Fibrinogen binding and platelet retention: relationship with thrombogenicity of catheters. J. Biomed. Mat. Res. 30: 101– 108.
4. Baron, P.,, L. D. Traber,, D. L. Traber,, T. Nguyen,, M. Hollyoak,, J. P. Heggers,, and D. N. Herndon. 1994. Gut failure and translocation following burn and sepsis. J. Surg. Res. 57: 197– 204.
5. Baumgartner, J. N.,, and S. L. Cooper. 1996. Bacterial adhesion on polyurethane surfaces conditioned with thrombus components. ASAIO J. 42: M476– M479.
6. Bayer, A. S.,, D. Cheng,, M. R. Yeaman,, G. R. Corey,, R. S. McClelland,, L. J. Harrel,, V. G. Fowler, Jr. 1998. In vitro resistance to thrombin-induced platelet microbicidal protein among clinical bacteremic isolates of Staphylococcus aureus correlates with and endovascular infectious source. Antimicrob. Agents Chemother. 42: 3169– 3172.
7. Beck, C.,, J. Dubois,, A. Grignon,, J. Lacroix,, and M. David. 1998. Incidence and risk factors of catheter-related deep vein thrombosis in a pediatric intensive care unit: a prospective study. J. Pediatr. 133: 237– 241.
8. Casanova, M.,, J. L. Lopez-Ribot,, C. Monteagudo,, A. Llombart-Bosch,, R. Sentandreu,, and J. P. Martinez. 1992. Indentification of a 58-kilodalton cell surface fibrinogen-binding mannoprotein from Candida albicans. Infect. Immun. 60: 4221– 4229.
9. Danzig, L. E.,, L. J. Short,, K. Collins,, M. Mahoney,, S. Sepe,, L. Bland,, and W. R. Jarvis. 1995. Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy. JAMA 273: 1862– 1864.
10. Darouiche, R. O.,, I. I. Raad,, S. O. Heard,, J. I. Thornby,, O. C. Wenker,, A. Gabrielli,, J. Berg,, N. Khardori,, H. Hanna,, R. Hachem,, R. L. Harris,, G. May hall, and Catheter Study Group. 1999. A comparison of two antimicrobial-impregnated central venous catheters. N. Engl. J. Med. 340: 1– 8.
11. Darouiche, R. O.,, H. Safar,, and I. I. Raad. 1997. In vitro efficacy of antimicrobial-coated bladder catheters inhibiting bacterial migration along catheter surface. J. Infect. Dis. 176: 1109– 1112.
12. Davies, D. G.,, M. R. Parsek,, J. P. Pearson,, B. H. Iglewski,, J. W. Costerton,, and E. P. Greenberg. 1998. The involvement of cell-to-cell signals in the development of a bacterial biofilm. Science 280: 295– 298.
13. Elliott, T. S. J.,, H. A. Moss,, S. E. Tebbs,, I. C. Wilson,, R. S. Bonser,, T. R. Graham,, L. P. Burke,, and M. H. Faroqui. 1997. Novel approach to investigate a source of microbial contamination of central venous catheters. Eur. J. Clin. Microbiol. Infect. Dis. 16: 210– 213.
14. Everitt, N. J.,, D. W. Krupowicz,, J. A. Evans,, and M. J. McMahon. 1997. Ultrasonographic investigation of the pathogenesis of infusion thrombophlebitis. Br. J. Surg. 84: 642– 645.
15. Falcieri, E.,, P. Vaudaux,, E. Huggler,, D. Lew,, and F. Waldvogel. 1987. Role of bacterial exopolymers and host factors on adherence and phagocytosis of Staphylococcus aureus in foreign body infections. J. Infect. Dis. 155: 524– 531.
16. Flock, J. I.,, S. A. Hienz,, A. Heimdahl,, and T. Schennings. 1996. Reconsideration of the role of fibronectin binding in endocarditis caused by Staphylococcus aureus. Infect. Immun. 64: 1876– 1878.
17. Francis, C. W.,, A. H. Felcher,, J. White,, J. V. Braaten,, and R. Goss. 1997. Thrombin activity associated with indwelling central venous catheters. Thromb. Haemostasis 77: 48– 52.
18. Francois, P.,, P. Vaudaux,, N. Nurdin,, H. J. Mathieu,, P. Descouts,, and D. P. Lew. 1996. Physical and biological effects of a surface coating procedure on polyurethane catheters. Biomaterials 17: 667– 678.
19. Frebourg, N. B.,, B. Cauliez,, and J. F. Lemeland. 1999. Evidence of nasal carriage of mefhicillin-resistant staphylococci colonizing intravascular devices. J. Clin. Microbiol. 37: 1182.
20. Galliani, S.,, A. Cremieux,, P. van der Auwera,, and M. Viot. Influence of strain, biomaterial, proteins, and onchostatic chemotherapy on Staphylococcus epidermidis adhesion to intravascular catheters in vitro. J. Lab. Clin. Med. 127: 71– 80.
21. Gaur, N. K.,, and S. K. Klotz. 1997. Expression, cloning, and characterization of Candida albicans gene, ALA1, that confers adherence properties upon Saccharomyces cerevisiae for extracellular matrix proteins. Infect. Immun. 65: 5289– 5294.
22. Gilbert, D. N.,, R. J. Dworkin,, S. R. Räber,, and J. E. Leggett. 1997. Outpatient parenteral antimicrobial-drug therapy. N. Engl. J. Med. 337: 829– 838.
23. Hampton, A. A.,, and R. J. Sherertz. 1988. Vascular-access infections in hospitalized patients. Surg. Clin. N. Am. 68: 57– 71.
24. Hardman, A. M.,, G. S. Stewart,, and P. Williams. 1998. Quorum sensing and the cell-cell communication dependent regulation of gene expression in pathogenic and non-pathogenic bacteria. Antonie Leeuwenhoek 74: 199– 210.
25. Indorf, A. S.,, T. Poate,, R. J. Sherertz. 1999. Neutrophil Chemotaxis on silicone and polyurethane surfaces. J. Infect. Dis. 180: 1603– 1607.
26. Jakab, E.,, M. Paulson,, F. Ascencio,, and A. Ljungh. 1993. Expression of vitronectin and fibronectin binding by Candida albicans yeast cells. APMIS 101: 187– 193.
27. John, S. F.,, M. R. Derrick,, A. E. Jacob,, and P. S. Handly. 1996. The combined effects of plasma and hydrogel coating on adhesion of Staphylococcus epidermidis and Staphylococcus aureus to polyurethane catheters. FEMS Microbiol. Lett. 144: 241– 247.
28. Kellerman, S.,, D. K. Shay,, J. Howard,, C. Goes,, J. Feusner,, J. Rosenberg,, D. J. Vugia,, and W. R. Jarvis. 1996. Bloodstream infections in home infusion patients: the influence of race and needleless access devices. J. Pediatr. 129: 711– 717.
29. Klotz, S. A. 1994. Plasma and extracellular matrix proteins mediate in the fate of Candida albicans in the human host. Med. Hypoth. 42: 328– 334.
30. Klotz, S. A.,, R. L. Smith,, and B. W. Stewart 1992. Effect of an arginine-glycine-aspartic acid-containing peptide on hematogenous candidal infections in rabbits. Antimicrob. Agents Chemother. 36: 132– 136.
31. Kojima, Y.,, M. Tojo,, D. A. Goldmann,, T. D. Tosteson,, and G. B. Pier. 1990. Antibody to the capsular polysaccharide/adhesin protects rabbits against catheter-related bacteremia due to coagulase-negative staphylococci. J. Infect. Dis. 162: 435– 441.
32. Kräfte-Jacobs, B.,, C. J. Sivit,, R. Mejia,, M. M. Pollack. 1995. Catheter-related thrombosis in critically ill children: comparison of catheters with and without heapin bonding. J. Pediatr. 126: 50– 54.
33. Kreft, B.,, S. Ilic,, W. Ziebuhr,, A. Kahl,, U. Frei,, K. Sack,, and M. Trautmann. 1998. Adherence of Staphylococcus aureus isolated in peritoneal dialysis-related exit-site infections to HEP-2 cells and silicone peritoneal catheter materials. Nephrol. Dial. Transplant 13: 3160– 3164.
34. Livesly, M. A.,, S. E. Tebbs,, M. A. Moss,, M. H. Faroqui,, P. A. Lambert,, and T. S. Elliott. 1998. Use of pulsed field gel electrophoresis to determine the source of microbial contamination of central venous catheters. Eur. J. Clin. Microbiol. Infect. Dis. 17: 108– 112.
35. Mackel, D. C.,, D. G. Maki,, R. L. Anderson,, F. S. Rhame,, and J. V. Bennett 1975. Nationwide epidemic of septicemia caused by contaminated intravenous products: mechanisms of intrinsic contamination. J. Clin. Microbiol. 2: 486– 497.
36. Maki, D. G., 1994. Infections caused by intravascular devices used for infusion therapy: pathogenesis, prevention, and management, p. 155– 212. In A. L. Bisno, and F. A. Waldvogel (ed.), Infections Associated with Indwelling Medical Devices, 2nd ed. ASM Press, Washington, D.C.
37. Maki, D. G.,, C. J. Alvarado,, and M. A. Ringer. 1991. A prospective, randomized trial of povidone-iodine, alcohol and Chlorhexidine for prevention of infection with central venous and arterial catheters. Lancet 338: 339– 343.
38. Maki, D. G.,, S. M. Stolz,, S. Wheeler,, and L. A. Mermel. 1997. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. Ann. Intern. Med. 127: 257– 266.
39. Marosok, R.,, R. Washburn,, A. Indorf,, and R. Sherertz. 1995. Contribution of vascular catheter material to the pathogenesis of infection: depletion of complement by silicone elastomer in vitro. J. Biomed. Mater. Res. 30: 245– 250.
40. McAndrew, H. F.,, D. A. Lloyd,, R. Rintala,, and H. K. van Saene. 1999. Intravenous glutamine or short-chain fatty acids reduce central venous catheter infection in a model of total parenteral nutrition. J. Pediatr. Surg. 34: 281– 285.
41. McDevitt, D.,, T. Nanavary,, K. House-Pompeo,, E. Bell,, N. Turner,, L. McIntire,, T. Foster,, and M. Hook. 1997. Characterization of the interaction between the Staphylococcus aureus clumping factor and fibrinogen. Eur. J. Biochem. 247: 416– 424.
42. McDonald, L. C.,, S. N. Banerjee,, and W. R. Jarvis. 1998. Line-associated bloodstream infections in pediatric intensive-care-unit patients associated with a needleless device and intermittent intravenous therapy. Infect. Control Hosp. Epidemiol. 19: 772– 777.
43. McKenney, D.,, J. Hubner,, E. Muller,, Y. Wang,, D. A. Goldmann,, and G. B. Pier. 1998. The ica locus of Staphylococcus epidermidis encodes production of the capsular polysaccharide/adhesin. Infect. Immun. 66: 4711– 4720.
44. Mermel, L.,, R. Sherertz,, I. Raad,, B. Farr,, N. O'Grady,, J. Harris,, and D. Craven. Guidelines for the management of intravascular catheter-related infections. IDSA Guideline for Intravenous Catheter Infection Subcommittee. Clin. Infect. Dis., in press.
45. Mhic Iomhair, M.,, and S. M. Lavelle. 1996. The antithrombotic effect of some EUROBIOMAT project test polymers in vivo. Technol. Health Care 4: 385– 388.
46. Mian, N. Z.,, R. Bayly,, D. M. Schreck,, E. B. Besserman,, and D. Richmand. 1997. Incidence of deep venous thrombosis associated with femoral venous catheterizatio. Acad. Emerg. Med. 4: 1118– 1121.
47. Nielsen, J.,, S. D. Ladefoged,, and H. J. Kolmos. 1998. Dialysis catheter-related septicaemia—focus on Staphylococcus aureus septicaemia. Nephrol. Dial. Transplant. 13: 2847– 2852.
48. Nouwen, J. L.,, A. van Belkum,, S. de Marie,, J. Slugs,, J. J. Wielenga,, J. A. Kluytmans,, and H. A. Berbrugh. 1998. Clonal expansion of Staphylococcus epidermidis strains causing Hickman catheter-related infections in a hemato-oncologic department. J. Clin. Microbiol. 36: 2696– 2702.
49. Nowak-Gottl, U.,, A. Dubbers,, D. Kececioglu,, H. G. Koch,, S. Kotthoff,, J. Runde,, and H. Vielhaber. 1997. Factor V Leiden, protein C., and liproprotein (a) in catheter-related thrombosis in childhood: a prospective study. J. Pediatr. 131: 608– 612.
50. Nozohoor, S.,, A. Heimdahl,, P. Colque-Navarro,, I. Julander,, B. Soderquist,, and R. Mollby. 1998. Virulence factors of Staphylococcus aureus in the pathogenesis of endocarditis. A comparative study of clinical isolates. Zentralbl. Bakteriol. 287: 433– 437.
51. Otto, M.,, R. Sussmuth,, G. Jung,, and F. Gotz. 1998. Structure of the pheromone peptide of the Staphylococcus epidermidis agr system. FEBS Lett. 424: 89– 94.
52. Passerini, L.,, P. T. Phang,, F. L. Jackson,, K. Lam,, J. W. Costerton,, and E. G. King. 1987. Biofilms on right heart flow-directed catheters. Chest 92: 440– 446.
53. Press, O. W.,, P. G. Ramsey,, E. B. Larson,, A. Fefer,, R. O. Hickman. 1984. Hickman catheter infections in patients with malignancies. Medicine 63: 189– 200.
54. Raad, I.,, A. Buzaid,, J. Rhyne,, R. Hachem,, R. Darouiche,, H. Safar,, M. Albitar,, and R. J. Sherertz. 1997. Minocycline and ethylenediaminetetraacetate for the prevention of recurrent vascular catheter infections. Clin. Infect. Dis. 25: 149– 151.
55. Raad, I.,, W. Costerton,, U. Sabharwal,, M. Sacilowski,, E. Anaissie,, and G. P. Bodey. 1993. Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and cura-tion of placement. J. Infect. Dis. 168: 400– 407.
56. Raad, I.,, R. Darouiche,, J. Dupuis,, D. Abi-Said,, A. Gabrielli,, R. Hachem,, M. Wall,, R. Harris,, J. Jones,, A. Buzaid,, C. Robertson,, S. Shenaq,, P. Curling,, T. Burke,, and C. Ericsson. 1997. Texas Medical Center Catheter Study Group. Ann. Intern. Med. 127: 267– 275.
57. Raad, I. I.,, R. O. Darouiche,, R. Hachem,, D. Abi-Said,, H. Safar,, T. Darnule,, M. Mansouri,, and D. Morck. 1998. Antimicrobial durability and rare ultrastructural colonization of indwelling central catheters coated with minocycline and rifampin. Crit. Care Med. 26: 219– 224.
58. Raad, I. I.,, D. C. Hohn,, B. J. Gilbreath,, N. Suleiman,, L. A. Hill,, P. A. Bruso,, K. Marts,, P. F. Mansfield,, and G. P. Bodey. 1994. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect. Control Hosp. Epidemiol. 15: 231– 238.
59. Raad, I. I.,, M. Luna,, S-. A M. Khalil,, J. W. Costerton,, C. Lam,, and G. P. Bodey. 1994. The relationship between the thrombotic and infectious complications of central venous catheters. JAMA 271: 1014– 1016.
60. Randolph, A. G.,, D. J. Cook,, C. A. Gonzales,, and M. Andrew. 1998. Benefit of heparin in central venous and pulmonary artery catheters: a meta-analysis of randomized controlled trials. Chest 113: 165– 171.
61. Riordan, M.,, P. L. Weiden,, and V. Factor. 1998. Leiden mutation does not account for central venous catheter-related thrombosis. Am. J. Hematol. 58: 150– 152.
62. Ruiz-Diez, B.,, V. Martinez,, M. Alvarez,, J. L. Rodriguez-Tudela,, and J. V. Martinez-Suarez. 1997. Molecular tracking of Candida albicans in a neonatal intensive care unit: long-term colonizations versus catheter-related infections. J. Clin. Microbiol. 35: 3032– 3036.
63. Runkel, N. S.,, F. G. Moody,, G. S. Smith,, F. F. Rodríguez,, M. T. LaRocco,, and T. A. Miller. The role of the gut in the development of sepsis in acute pancreatitis. J. Surg. Res. 51: 18– 23.
64. Runyon, B. A.,, S. Squier,, and M. Borzio. 1994. Translocation of gut bacteria in rats with cirrhosis to mesenteric lymph nodes partially explains the pathogenesis of spontaneous bacterial peritonitis. J. Hepatol. 21: 792– 796.
65. Rupp, M. E.,, J. S. Ulphani,, P. D. Fey,, K. Bartscht,, and D. Mack. 1999. Characterization of the importance of polysaccharide intercellular adhesin/hemagglutinin of Staphylococcus epidermidis in the pathogenesis of biomaterial-based infection in a mouse model of foreign body infection. Infect. Immun. 67: 2627– 2632.
66. Rupp, M. E.,, J. S. Ulphani,, P. D. Fey,, K. Bartscht,, and D. Mack. 1999. Essential functional role of the polysaccharide intercellular adhesin of Staphylococcus epidermidis in hemagglutination. Infect. Immun. 67: 1004– 1008.
67. Rupp, M. E.,, J. S. Ulphani,, P. D. Fey,, and D. Mack. 1999. Characterization of Staphylococcus epidermidis polysaccharide intercellular adhesin/hemagglutinin in the pathogenesis of intravascular catheter-associated infection in a rat model. Infect. Immun. 67: 2656– 2659.
68. Scheid, W. M.,, R. W. Strunk,, G. Balian,, R. A. Calderone. 1985. Microbial adhesion to fibronectin in vitro correlates with production of endocarditis in rabbits. Proc. Soc. Exp. Biol. Med. 180: 474– 482.
69. Schwartz, C.,, K. J. Henrickson,, K. Roghmann,, and K. Powell. 1990. Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms. J. Clin. Oncol. 8: 1591– 1597.
70. Sedman, P. C.,, J. Macfie,, P. Sagar,, C. J. Mitchell,, J. May,, B. Mancey-Jones,, and D. Johnstone. 1995. The prevalence of gut translocation in humans. Gastroenterology 107: 643– 649.
71. Segura, M.,, F. Alvarez-Lerma,, J. M. Tellado,, J. Jimenez-Ferreres,, L. Oms,, J. Relio,, T. Baro,, R. Sanchez,, A. Morera,, D. Mariscal,, J. Marrugat,, and A. Sitges-Serra. 1996. A clinical trial on the prevention of catheter-related sepsis using a new hub model. Ann. Surg. 223: 363– 369.
72. Sesso, R.,, D. Barbosa,, I. L. Lerne,, H. Sader,, M. E. Canziani,, S. Manfredi,, S. Draibe,, and A. C. Pignatari. 1998. Staphylococcus aureus prophylaxis in hemodialysis patients using central venous catheters: effect of mupirocin ointment. J. Am. Soc. Nephrol. 9: 1085– 1092.
73. Sherertz, R. J., 1997. Pathogenesis of vascular catheter-related infections, p. 1– 30. In H. Seifert,, B. Jansen,, and B. M. Farr (ed.), Catheter-Related Infections. Marcel Dekker, Inc., New York, N.Y.
74. Sherertz, R. J.,, W. A. Carruth,, R. D. Marosok,, M. A. Espeland,, R. A. Johnson,, and D. D. Solomon. 1995. Contribution of vascular catheter material to the pathogenesis of infection: the enhanced risk of silicone in vivo. J. Biomed. Mater. Res. 29: 635– 645.
75. Sherertz, R. J.,, E. W. Ely,, D. M. Westbrook,, K. S. Gledhill,, S. A. Streed,, B. Kiger,, L. Flynn,, S. Hayes,, S. Strong,, J. Cruz,, D. L. Bowton,, T. Hulgan,, and E. F. Haponik. 2000. Education of training physicians can decrease the risk of vascular catheter infections. Ann. Intern. Med. 132: 641– 648.
76. Sherertz, R. J.,, K. S. Gledhill,, K. D. Hampton,, M. A. Pfaller,, L. B. Givner,, J. S. Abramson,, and R. G. Dillard. 1992. Outbreak of Candida bloodstream infections associated with retrograde medication administration in a neonatal intensive care unit. J. Pediatr. 120: 455– 461.
77. Sherertz, R. J.,, I. I. Raad,, A. Belani,, L. C. Koo,, K. H. Rand,, D. L. Pickett,, S. A. Straub,, and L. L. Fauerbach. 1990. Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J. Clin. Microbiol. 28: 26– 82.
78. Stickler, D. J.,, N. S. Morris,, R. J. McLean,, and C. Fuqua. 1998. Biofilms on indwelling urethral catheters produce quorum-sensing signal molecules in situ and in vitro. Appl. Environ. Microbiol. 64: 3486– 3490.
79. Sullam, P. M.,, A. S. Bayer,, W. M. Foss,, and A. L. Cheung. 1996. Diminished platelet binding in vitro by Staphylococcus aureus is associated with reduced virulence in a rabbit model of infective endocarditis. Infect. Immun. 64: 4915– 4921.
80. Takeda, S.,, G. B. Pier,, Y. Kojima,, M. Tojo,, E. Miller,, T. Tosteson,, and D. A. Goldmann. 1991. Protection against endocarditis due to Staphylococcus epidermidis by immunization with capsular polysaccharide/adhesin. Circulation 84: 2539– 2546.
81. Tenney, J. J.,, M. R. Moody,, K. A. Newman,, and S. C. Schimpff. 1986. Adherent microorganisms on lumenal surfaces of long-term intravenous catheters. Arch. Intern. Med. 146: 1949– 1954.
82. Timsit, J. F.,, J. C. Farkas,, J. M. Boyer,, J. B. Martin,, B. Misset,, B. Renaud,, and J. Carlet. 1998. Central vein catheter-related thrombosis in intensive care patients: incidence, risk factors, and relationship with catheter-related sepsis. Chest 114: 207– 213.
83. Vaudaux, P. E.,, P. Francois,, R. A. Proctor,, D. McDevitt,, T. J. Foster,, R. M. Albrecht,, D. P. Lew,, H. Wabers,, and S. L. Cooper. 1995. Use of adhesion-defective mutants of Staphylococcus aureus to define the role of specific plasma proteins in promoting bacterial adhesion to canine arteriovenous shunts. Infect. Immun. 63: 585– 590.
84. Vaudaux, P.,, D. Pittet,, A. Haeberli,, E. Huggler,, U. E. Nydegger,, D. P. Lew,, and F. A. Waldvogel. 1989. Host factors selectively increase staphylococcal adherence on inserted catheters: a role for fibronectin and fibrinogen or fibrin. J. Infect. Dis. 160: 865– 875.
85. Vaudaux, P.,, D. Pittet,, A. Haeberli,, P. G. Lerch,, J. J. Morgenthaler,, R. A. Proctor,, F. A. Waldvogel,, D. P. Lew. 1993. Fibronectin is more active than fibrin or fibrinogen in promoting Staphylococcus aureus adherence to inserted intravascular devices. J. Infect. Dis. 167: 633– 641.
86. Voss, A.,, W. J. Melchers,, D. Bijl,, J. A. Hoogkamp-Korstanje,, and J. F. Meis. 1996. Staphylococcus epidermidis catheter-related infections in a short-bowel patient. Persistence of a single strain over a two-year period. Infect. Control Hosp. Epidemiol. 17: 669– 671.
87. Wells, C. L.,, R. P. Jechorek,, S. B. Olmsted,, and S. L. Erlandsen. 1994. Bacterial translocation in cultured enterocytes: magnitude, specificity, and electron microscopic observations of endocytosis. Shock 1: 443– 451.
88. Wen, Y. R.,, W. Y. Ho,, W. Z. Sun,, C. H. Or,, M. Yeh,, W. C. Yao,, and Y. T. Tai. 1997. Thromboelastographic study of thrombosis in the implantable central venous access device. Acta Anaesth. Sínica 35: 223– 228.
89. Wenzel, R. P.,, and M. B. Edmond. 1999. The evolving technology of venous access. N. Engl. J. Med. 340: 48– 50.
90. Wesson, C. A.,, L. E. Liou,, K. M. Todd,, G. A. Bohach,, W. R. Trumble,, and K. W. Bayles. 1998. Staphylococcus aureus Agr and Sar regulators influence internalization and induction of apopotosis. infect. Immun. 66: 5238– 5243.
91. Wolz, C.,, D. McDevitt,, T. J. Foster,, and A. L. Cheung. 1996. Influence of agr on fibrinogen binding in Staphylococcus aureus Newman. Infect. Immun. 64: 3142– 3147.
92. Xiang, D. Z.,, E. K. Verbeken,, A. T. van Lommel,, M. Stas,, I. de Wever. 1998. Composition and formation of the sleeve enveloping a central venous catheter. J. Vase. Surg. 28: 260– 271.
93. Yan, S.,, E. Negre,, J. A. Cashel,, N. Guo,, C. A. Lyman,, T. J. Walsh,, and D. D. Roberts. 1996. Specific induction of fibronectin binding activity by hemoglobin in Candida albicans grown in defined media. Infect. Immun. 64: 2930– 2935.
94. Zaidi, A. K.,, L. J. Harreil,, J. R. Rost,, and L. B. Reller. 1996. Assessment of similarity among coagulase-negative staphylococci from sequential blood cultures of neonates and children by pulsed-field gel electropheresis. J. Infect. Dis. 174: 1010– 1014.

References: V. 
 V. 
 V. 
 V. 
 V. 
 V.