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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.

References

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Osma, S., Kahveci, S., Akalin, H. et al. The efficacy of an antiseptic-impregnated catheter on catheter-related bloodstream infection in the ICU. Crit Care 7, P119 (2003). https://doi.org/10.1186/cc2008

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  • DOI: https://doi.org/10.1186/cc2008

Keywords

  • Catheter
  • Intensive Care Unit
  • Central Venous Catheter
  • Chlorhexidine
  • Maki