Double-lumen central venous catheters impregnated with chlorhexidine and silver sulfadiazine as a prevention of catheter colonization in the intensive care unit setting: a prospective randomized study

Introduction

Central venous catheters (CVC) are frequently used in the intensive care unit (ICU) setting. A wide number of strategies have been studied to prevent colonization and infection related to CVC. One of them is the use of antimicrobial-impregnated catheters, but a positive effect has been shown primarily for triple-lumen catheters.

Objective

To compare the incidence of CVC colonization in two groups of patients using a double-lumem central venous catheter impregnated with chlorhexidine and silver sulfadiazine or the standard one.

Patients and methods

Patients who undergo insertion of a double-lumen CVC in the ICU were randomized to receive either a central venous catheter impregnated with chlorhexidine and silver sulfadiazine or the standard one. The catheters tips were cultured by the roll-plate method after removal.

Results

One hundred and nine patients enrolled with successful insertion of 109 catheters, 51 of them impregnated (group 1) and 58 standards (group 2). There were no statistically significant differences between the groups in age, seven infection-related risk factors, ICU diagnosis, mean SOFA score, insertion sites, duration of catheterization, wrong location at X-ray, signs of allergy, and catheter colonization rates. The mean times of duration of catheterization in group 1 and group 2 were 15.1 ± 9.5 days and 13.5 ± 8.1 days, respectively (P = 0.3). The mean SOFA scores in groups 1 and 2 were 5.04 ± 2.9 and 4.9 ± 3.1, respectively (P = 0.8). The colonization rates were 29.4% (15 catheters) in group 1 and 34.5% (20 catheters) in group 2 (P = 0.5). Thirty-one catheters presented Gram-positive cocci, four of them associated with Gram-negative bacilli and tyree with fungi. Three catheters presented Gram-negative bacilli alone and one catheter presented fungi alone in the roll-plate.

Conclusion

This comparative study between a double-lumen central venous catheter impregnated with chlorhexidine and silver sulfadiazine and the standard one did not show any statistically significant difference in colonization rates between the two groups.