Tissue adhesives for bacterial inhibition in extracorporeal membrane oxygenation cannulae

Ms India Pearse¹, Dr Yue Qu^2,3, Prof John F Fraser¹, Ms Amanda Corley^1,4

¹Critical Care Research Group, The Prince Charles Hospital and University of Queensland, Chermside, Australia
²Biomedicine Discovery Institute, Department of Microbiology, School of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
³Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
⁴Nursing and Midwifery Research Centre, Royal Brisbane and Women’s Hospital, Herston, Australia

Introduction

One of the most serious complications of extracorporeal membrane oxygenation (ECMO) therapy is ECMO cannulae infection, which can occur at quadruple the rate of central venous catheter infections, and significantly impact morbidity and paediatric mortality. The objective of this in vitro observational study was to assess antimicrobial properties of two n-butyl-2-octyl cyanoacrylate tissue adhesive (TA) formulations for bacterial inhibition at peripheral ECMO cannulae insertion sites.

Methods

Antimicrobial properties were assessed using modified agar disk-diffusion (n=3) and simulated agar cannulation insertion site (n=20) models. Both assays used Staphylococcus epidermidis which was seeded at the edge of the TA or dressing. Microorganism inhibition was visually inspected and evidenced by the presence or absence of a TA bacterial inhibition zone at 24 and 72 hours.

Results

Both TAs provided effective barriers to bacterial migration under cannula dressings, to cannula insertion sites and down cannula tunnels. Additionally, both TAs demonstrated distinct zones of inhibition produced when left to polymerize onto agar plates seeded with S. epidermidis.

Conclusions

N-butyl-2-octyl cyanoacrylate TA appears to inhibit bacterial growth and migration of S. epidermidis. Application of TA to cannulae insertion sites may therefore be a potential bedside strategy for infection prevention in ECMO cannulae but requires further testing before being used clinically for this purpose.

Biography:

India Pearse is a Nurse Researcher within the Critical Care Research Group at The Prince Charles Hospital in Brisbane. She is currently undertaking a PhD.