Transient Bacteremia Promotes Catheter-Related Central Venous Thrombosis through Neutrophil Extracellular Traps

Jeng Wei Chen, Chih Chieh Hsu, Chien Chia Su, Ron Bin Hsu, Yen Ling Chiu, Chiau Jing Jung, Jean San Chia

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Formation of intravenous catheter-related thrombosis leads to central venous stenosis in patients requiring renal replacement therapy or chemotherapy infusion, yet the triggers or mechanisms remain unclear, especially in patients without symptoms of infection. In this study, we found that neutrophil extracellular traps (NETs) could be detected in the fibrin sheaths from dialysis patients without clinical manifestations of infection. Confocal microscopy revealed bacteria imbedded in NETs in the fibrin sheaths. Thirty-nine of 50 (78%) fibrin sheath specimens contained bacteria detectable by 16S ribosomal RNA genome typing with a predominance of Staphylococcus aureus (69%). In rat models, transient bacteremia of S. aureus induced NETs in enlarged fibrin sheaths, and treatment with DNase I alone significantly reduced both NET and fibrin sheath formation surrounding the catheter. Therefore, transient bacteremia could be a silent trigger that induces NET-related immunothrombosis enhancing catheter-related central venous stenosis.

Original languageEnglish
Pages (from-to)1198-1208
Number of pages11
JournalThrombosis and Haemostasis
Volume122
Issue number7
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • catheter-related central venous thrombosis
  • neutrophil extracellular traps
  • Staphylococcus aureus
  • transient bacteremia

ASJC Scopus subject areas

  • Hematology

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