, Volume 30, Issue 5, pp 837-843
Date: 02 Apr 2004

Prevention of intravascular catheter-related infection with newer chlorhexidine-silver sulfadiazine-coated catheters: a randomized controlled trial

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Abstract

Background

The indication of antiseptic-coated catheters remains debated.

Objective

To test the ability of the new generation of chlorhexidine-silver and sulfadiazine-coated catheters, with enhanced antiseptic coating, to reduce the risk of central venous catheter (CVC)-related infection in ICU patients.

Design

Multicentre randomized double-blind trial.

Patients and setting

A total of 397 patients from 14 ICUs of university hospitals in France.

Intervention

Patients were randomized to receive an antiseptic-coated catheter (ACC) or a standard non-coated catheter (NCC).

Measurements

Incidence of CVC-related infection.

Results

Of 367 patients having a successful catheter insertion, 363 were analysed (175 NCC and 188 ACC). Patients had one (NCC=162, ACC=180) or more (NCC=13, ACC=11) CVC inserted. The two groups were similar for insertion site [subclavian (64 vs 69)] or jugular (36 vs 31%)], and type of catheters (single-lumen 18 vs 18%; double-lumen 82 vs 82%), and mean (median) duration of catheterisation [12.0±11.7 (9) vs 10.5±8.8 (8) days in the NCC and ACC groups, respectively]. Significant colonisation of the catheter occurred in 23 (13.1%) and 7 (3.7%) patients, respectively, in the NCC and ACC groups (11 vs 3.6 per 1000 catheter-days; p=0.01); CVC-related infection (bloodstream infection) occurred in 10 (5) and 4 (3) patients in the NCC and CC groups, respectively (5.2 vs 2 per 1000 catheter days; p=0.10).

Conclusions

In the context of a low baseline infection rate, ACC were associated with a significant reduction of catheter colonisation and a trend to reduction of infection episodes, but not of bloodstream infection.

Participants of the Catheter Infection Prevention Study Group, co-authors of this article, are listed in the Appendix (electronic supplementary material). This work was presented in part at the International Conference of Antimicrobial Agents and Chemotherapy, San Francisco, October 2002.