PREVENTION OF CATHETER-RELATED INFECTIONS BY SILVER-COATED CENTRAL VENOUS CATHETERS IN ONCOLOGICAL PATIENTS

Catheter-related infection (CRI) is a serious complication of central venous catheterization. We have investigated the efficacy of a silver- coated polyurethane catheter (Pellethane, Fresenius AG, Germany) in pr eventing CRI in oncological patients receiving chemotherapy in a phase II study. From November 1992 through April 1994, 266 patients were as signed to receive single lumen catheters, either standard uncoated cat heters (UC, n = 113) or silver-coated ones (SC, n = 120). Catheters we re inserted into the internal jugular vein after institutional approva l and informed consent. Duration of catheterization (UC vs. SC = 13.3 vs. 12.7 days) and leukopenia (< 1.0 x 10(9) WBC/l; 4.3 vs. 3.6 days) were similar in both groups demonstrating a comparable risk for infect ions. Skin reactions at the catheter entry site were recorded daily. C RI and colonization rates were studied by semiquantitatively culturing intradermal and intravascular segments. CRI were confirmed by blood c ultures obtained via catheter and from peripheral veins in cases of su spected sepsis or at the end of catheterization. No adverse effects fr om the silver-coated catheter could be observed. The bacteriological r esults showed that SC were colonized (> 15 CFU) in 45.1% and UC in 44. 2%. CRI developed in 21.2% of the UC patients but only in 10.2% of the SC patients (p = 0.011). We conclude that this new silver-coated cent ral venous catheter is biocompatible and effective in reducing the inc idence of catheter-related infections in oncological patients.