A CLINICAL-TRIAL ON THE PREVENTION OF CATHETER-RELATED SEPSIS USING ANEW HUB MODEL

Background Catheter hub contamination is being increasingly recognized as a source of catheter-related sepsis. The authors have investigated the efficacy of a new hub design in preventing endoluminal catheter c ontamination and catheter-related sepsis arising at the hub. Methods A dult surgical and intensive care patients requiring a subclavian cathe ter for at least 1 week were randomly assigned to receive catheters wi th standard connectors (control group, n = 73) or equipped with a new hub model (new hub group, n = 78). Skin, catheter tip, and hub culture s were performed at the time the catheter was withdrawn because therap y was terminated or because of suspicion of sepsis, in which case peri pheral blood cultures were taken. Results Of the 151 patients included , 15 (10%) developed catheter-related sepsis. Catheters were more ofte n withdrawn because suspicion of infection in the control group (42 vs . 19%, p < 0.005). Catheter sepsis rate was higher in the control grou p (16 vs. 4%, p < 0.01) because of the low rate of catheter sepsis ari sing the hub observed in the new hub group (1 vs. 11%, p ( 0.01). The prevalence of culture-positive catheter hubs without associated bacter emia (colonization) was higher in the control group (18 vs. 5%, p < 0. 03). Conclusions A new catheter hub has proved to be useful in prevent ing endoluminal bacterial colonization and catheter-related sepsis in subclavian lines inserted for a mean of 2 weeks.