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In vitro assessment of bacterial colonisation rates of goat umbilical cord segments using three embodiments of a novel neonatal umbilical catheter protection device
  1. Carl L Dambkowski1,
  2. Eric F Chehab2,
  3. Joseph D Shih2,
  4. Ross Venook2,
  5. James K Wall2,3
  1. 1Department of Emergency Medicine, Stanford Health Care, Palo Alto, California, USA
  2. 2Department of Bioengineering, Stanford University, Stanford, California, USA
  3. 3Division of Pediatric Surgery, Stanford Children's Health, Palo Alto, California, USA
  1. Correspondence to Dr Carl L Dambkowski, Department of Emergency Medicine, Stanford Health Care, 300 Pasteur Drive, Palo Alto 94305, CA, USA; carld{at}stanford.edu

Abstract

Introduction Central line-associated bloodstream infections (CLABSIs) in neonates with umbilical catheters occur at a rate that is 5 times higher than CLABSIs in adults with central catheters. No device currently exists tailored to the unique constraints umbilical catheters pose. The current study examined the natural progression of bacterial colonisation in goat umbilical cords and the relationship between embodiments of a novel neonatal umbilical catheter protection device and bacterial colonisation rates. The authors hypothesise that device venting is required to minimise bacterial colonisation in the unique umbilical stump environment.

Methods The natural progression of bacterial colonisation in goat umbilical cord segments was studied by examining bacterial colonisation rates each day over 7 days. To understand the relationship between protection and bacterial colonisation, umbilical catheters were placed in goat umbilical cord segments and secured with 1 of 3 embodiments of a novel umbilical catheter protection device, which offered varying degrees of venting. After a 7-day period of incubation, colony counts were compared.

Results Bacterial load was largest when umbilical cord segments were fresh and subsequently decreased over time. Further, bacterial colonisation rates showed a statistically significant difference between device embodiments (F(2,9)=4.26, p<0.05), with the non-vented embodiment showing the highest bacterial colonisation rate.

Conclusions A device to better stabilise and protect umbilical catheters in order to reduce bloodstream infections in neonates is greatly needed. The current experiments confirm the hypothesis that completely enclosed, or non-vented, protection device will have increased bacterial growth.

  • Medical devices
  • Neonatal
  • Umbilical catheter
  • Infection
  • LIFEbubble™
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