A PROSPECTIVE, RANDOMIZED EVALUATION OF THE EFFECT OF SILVER IMPREGNATED SUBCUTANEOUS CUFFS FOR PREVENTING TUNNELED CHRONIC VENOUS ACCESS CATHETER INFECTIONS IN CANCER-PATIENTS

Objective This study was performed to evaluate the effect of a silver impregnated cuff on the incidence of catheter related bacteremia/funge mia or tunnel tract infection in cancer patients with chronic dual-lum en tunneled venous access catheters Summary Background Data Infection is a frequent and potentially life threatening complication of tunnele d chronic cuffed silastic central venous access catheters in cancer pa tients. Recent experience with antimicrobial silver-impregnated cuffs placed on nontunneled percutaneously inserted central venous catheters suggests that such a cuff may render the catheter less prone to infec tion. Methods The authors prospectively randomized 200 cancer patients to receive either a dual-lumen 10 French tunneled cuffed silastic cen tral venous access catheter or the same catheter with a second more pr oximal subcutaneous silver impregnated cuff. All patients then were fo llowed prospectively for infectious morbidity until the device was rem oved or the patient died. Results The hazard rate for infection/day (9 5% confidence limits) was 0.0022 (0.0015 to 0.0030) for standard cathe ters compared with 0.0027 (0.0019 to 0.0037) tor catheters with silver -impregnated cuffs (p = not significant). Regression analysis of infec tion-free interval of both catheter types shows no difference over the lifetime of catheter as well as the over the first 48 days after inse rtion, Conclusions The study indicated no effect of a silver-impregnat ed cuff in decreasing the incidence of catheter related bacteremias/fu ngemias, tunnel infections, or the spectrum of causative microorganism s involved in cancer patients with tunneled chronic venous access cath eters.