Successful Unconventional Treatment of Serratia Marcescens Exit-Site Infection in a Central Venous Catheter for Hemodialysis: A Case Report

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Sara Morales Palomares

DOI: 10.69097/41-06-2024-06

Silvia Cappelletti¹, Sara Morales Palomares2, Stefano Mancin3, Marco Sguanci4

1 Department of Nephrology and Dialysis, Sant’Anna Hospital, Territorial Social Health Company Lariana, Como, Italy
2 Department of Pharmacy, Health and Nutritional Sciences (DFSSN), University of Calabria, Rende, Italy
3 Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier, 1- 00128 Rome, Italy
4 A.O. Polyclinic San Martino Hospital, Genova

Corresponding author:
Sara Morales Palomares RN, PhD,
Department of Pharmacy, Health and Nutritional Sciences (DFSSN)
University of Calabria, Rende, Italy
Phone: +39 3404249439
Mail: sara.morales@unical.it

 

Abstract

Introduction. Central Catheter-related infections and biofilm formation are significant issues in the context of nosocomial infections that increase resistance to conventional therapies.
Methodology. This case report describes an unconventional treatment for a Serratia Marcescens Central Venous Catheter infection in a hemodialysis patient through the combination of polyguanide and betaine. Clinical evaluations were conducted using the Visual Exit-Site Score and culture swabs.
Results. After the first four treatment sessions there was a significant reduction in redness and pain (VES=1); the culture swab at the end of treatment was negative.
Conclusions. The results of this case report encourage further research on the effectiveness of non-antibiotic treatments.

Keywords: Exit-Site infection, Central Venous Catheter, Serratia Marcescens, Polyguanide, Betaine

Introduction

The increasing global incidence of chronic kidney disease (CKD) [1] underscores the importance of hemodialysis as a life-saving replacement therapy. In this context, the use of central venous catheters (CVCs) introduces significant risks, including the onset of infections at the exit site [2].

These infections, often caused by resistant pathogens like Serratia Marcescens, pose major challenges, affecting patients’ quality of life and prognosis [3, 4].

Catheter-related infections (CRIs) are a significant issue in healthcare, with biofilms providing microorganisms a protective environment, increasing resistance to conventional therapies. Studies show that 50-70% of microbial infections involve biofilms emphasizing the need for effective treatments [5]. As microbial resistance rises, researching alternatives to traditional antibiotics is crucial [6]. This case report outlines the phases and management of an innovative treatment for a Serratia Marcescens infection in a hemodialysis patient using polyguanide and betaine. This promising approach aims to enhance current clinical practices in managing CVC infections and offers a new strategy for CRIs caused by Serratia Marcescens.

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