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Author (up) Richardson, I.P.; Sturtevant, R.; Heung, M.; Solomon, M.J.; Younger, J.G.; VanEpps, J.S. url  doi
  Title Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment Type Journal Article
  Year 2016 Publication ASAIO Journal (American Society for Artificial Internal Organs : 1992) Abbreviated Journal Asaio J  
  Volume 62 Issue 1 Pages 92-99  
  Keywords Anti-Bacterial Agents/therapeutic use; *Biofilms; Catheter-Related Infections/drug therapy/microbiology/*therapy; Catheterization, Central Venous; Catheters, Indwelling/microbiology; Hot Temperature; Humans; Hydrodynamics; *Hyperthermia, Induced; Klebsiella Infections/physiopathology/*therapy; Klebsiella pneumoniae; Models, Cardiovascular; Renal Dialysis; Staphylococcal Infections/physiopathology/*therapy; Staphylococcus aureus; Staphylococcus epidermidis; Vancomycin/therapeutic use  
  Abstract Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50 degrees C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature.  
  Address From the *Department of Emergency Medicine, daggerDivision of Nephrology, Department of Internal Medicine, and double daggerDepartment of Chemical Engineering, University of Michigan, Ann Arbor, Michigan  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1058-2916 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:26501916 Approved no  
  Call Number ref @ user @ Serial 99282  
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