Central venous catheter related complications: can we reduce the infection burden?

The aims of this dissertation are to further study the incidence of catheter related infections (CRI) in detail, in selected an unselected cohorts, to map out and identify factors we can impact and optimise to reduce the infection burden. Further, we aim to optimise the use of central venous catheters (CVC) and to contribute with novel aspects to help us fight CRI by evaluating current CVC management and by examine different types of CVCs in patients with increased risk of infections. Moreover, we will study bacterial adhesion in different catheter materials ex vitro with the aim to adjust and individualise the choice of CVC material in different patients according to the most common CRI pathogens in different patient categories.

The dissertation will consist of five projects - all of which have been approved by the Ethical Board.
Project I: A retrospective observational study investigating the incidence of CRI before and after implementation of hygiene bundles.
Project II: A retrospective study on a selected high-risk cohort - haematology patient. The incidence of CVC related complications, CRI included, will be evaluated.
Project III: A before and after study after adjusting the CVC material used in hematology patient. This study is be based on the results presented in project II.
Project IV: Laboratory study evaluating bacterial adhesion to different catheter types. This is a collaborative study with Bactiguard, where catheter tips will be inoculated with most common pathogens for CRI, to then run it in an ex vitro venous system model (Chandlers Loop) to further evaluate how bacteria adhere to catheters when in contact with human blood.
Project V: Retrospective study evaluating the incidence of CRI and thrombosis in thromophilic patient - patients with severe COVID-19. The association between CRI and thrombosis will be evaluated.

In summary - these projects will help us identify an ongoing problem - CRI - and map out the incidence, especially in high-risk groups. Based on those results, we will adjust and optimise CVC management with the aim to personalise choice of catheter and hygiene aspects and in the future - to eliminate CRI.