CENTRAL VENOUS CATHETERS REVISITED - INFECTION-RATES AND AN ASSESSMENT OF THE NEW FIBRIN ANALYZING SYSTEM BRUSH

Sixty-one consecutive patients in the Intensive Care Unit requiring ce ntral venous lines (CVC) for five or more days were randomized to rece ive either a standard triple lumen CVC (STD/CVC) or a silver sulphadia zine and chlorhexidine impregnated CVC (SSD/CVC). Data from the 54 pat ients who completed the trial show a reduced infection rate (positive tip culture) in the SSD/CVC group (4 out of 28) compared to the STD/CV C group (10 out of 26) (P < 0.05). In addition, the new Fibrin Analysi ng System (FAS) brush was evaluated and used to determine the presence of infection in all the CVCs (STD/CVC and SSD/CVC combined, n=54) at day 3 (i.e. early warning of CVC colonization/infection) and at the ti me of removal of the CVC. The FAS brush was able to detect an infected CVC on only one occasion on day 3 out of the 14 CVC tips which were l ater found to be colonized/infected at the time of removal. The sensit ivity of the FAS brush in detecting colonized/infected CVCs at the tim e of CVC removal compared with CVC tip culture was 21% with a specific ity of 100%. These findings would currently not support the routine us e of the FAS brush in determining CVC infection/colonization.