Chest drain associated infection and the role of the impregnated drain to prevent colonisation.

Abstract

Chest tube insertions are one of the commonly used procedures in medicine. This procedure used to drain fluid and air collection in the pleural cavity that accumulates due to medical complications. The duration of the tube varies from a few days to weeks. Despite the enormous benefit of chest drains, risk and complications come with this procedure. Chest tube infection is one of those complications. Infection of the drain may increase morbidity, mortality, hospital stay and costs. Chest drains associated infection rates vary from 1-25%, and Staphylococcus aureus is the most common causative organism followed by gram-negative organisms. Preventing infection is vital to reduce morbidity, mortality, as well as the length of hospital stay and costs. In this study, removed chest drains were aseptically sonicated, and sonicates were cultured under aerobic and anaerobic conditions. Growing organisms identified using routine microbiological tests to determine common organisms and rate of infection. Also, serial plate transfer test (SPTT), time to kill 100% (TK100), and in vitro flow model (IVFM) tests were performed on commonly used types of chest tubes after antibiotics impregnation, to determine whether infection can be prevented by impregnation. SPTT test showed the superiority of the silicone material in both activity and sustainability of antimicrobials. However, the silicone TK100 and IVFM results were invalid due to control failure. The PVC shows less antimicrobials activity and sustainability but were able to prevent S. aureus colonisation minimum for seven days in the IVFM test; however, impregnation caused significant mechanical changes to the PVC.