The efficacy of an antiseptic-impregnated catheter on catheter-related bloodstream infection in the ICU

Aim

Despite improvement in central venous catheter (CVC) design and insertion techniques, catheter-related bloodstream infection (CRBI) continues to be a significant problem in the intensive care unit (ICU) [1]. Recently, CVCs impregnated with chlorhexidine and silver sulfadiazine (CCS) have been introduced for the prevention of CRBI [2, 3]. The objective of this study is to compare between the efficacy of CCS-impregnated CVC and a standard catheter during the CRBI incidences in the ICU.

Method

In this prospective study, we observed that 108 patients who needed a CVC were randomized to receive either a triple-lumen catheter impregnated with CCS (ARROWgard Blue, PA, USA; n = 54) or a standard triple-lumen catheter (Certofix^®; B/Braun, Melsungen, Germany; n = 54). We observed each patient from catheter insertion to removal, and collected data on patient-related factors. Catheters were removed when no longer needed or suspected as a cause of infection. The tip and a 5 cm segment of the intradermal portion of the catheter were cultured using the semiquantitative technique developed by Maki et al. [4]. If sepsis was suspected, peripheral venous blood samples, blood aspirated from the distal lumen and also approximately 20 cm² of the skin at the insertion site were cultured. Catheter colonization (CC) was defined as the presence of ≥ 15 CFUs. CRBI was defined as isolation of the same organism from a catheter segment semiquantitative culture and from a peripheral blood culture.

Results

Data are mean ± standard error of mean or the number of patients (Table 1).

Table 1

Conclusion

These findings suggest that a CVC impregnated with CCS does not affect the incidence and magnitude of CC and CRBI in long-term catheterization but it could be beneficial for short-term catheterization in critically ill patients.