Evaluation of antiseptic-impregnated central venous catheters for prevention of catheter-related infection in intensive care unit patients

Central venous catheterization represents a significant medical advancement , particularly in the treatment of critical ill. However, there is a high r isk of central venous catheters-related infection. A novel antiseptic centr al venous catheter, made of polyurethane and impregnated with chlorhexidine and silver sulfadiazine, was developed to reduce the risk of catheters-rel ated infection. In this study, we did a randomized clinical study to determ ine the efficacy by using antiseptic catheters for the prevention of centra l venous catheters related infection in the intensive care units. A total o f 204 patients with 235 central venous catheters were studied at the surgic al intensive care units at National Taiwan University Hospital between Nove mber 1998 and June 1999. Participants received either a standard triple-lum en polyurethane catheter or an antiseptic catheter (Arrow International, Re ading, Pennsylvania, USA). Both were indistinguishable from each other. Com pared to standard polyurethane catheters, antiseptic catheters were less li kely to be colonized by microorganisms when they were cultured at the remov al (8.0 versus 20.0 colonized catheters per 100 catheters; relative risk 0. 34 [95% CI, 0.15 to 0.74]; p < 0.01). There was no significant differences between both groups in catheter-related infections (0.9 versus 4.9 infectio ns per 100 catheters; relative risk 0.17 [95% CI, 0.03 to 1.15]; p = 0.07). Gram-positive cocci and fungi were more likely to colonize in the standard polyurethane catheters (p = 0.06 and 0.04, compared to antiseptic catheter s respectively). Two of our cases in the control group died directly due to catheter-related candidemia. No adverse reactions such as hypersensitivity or leukopenia were found in the antiseptic catheter group. Our study showe d that central venous catheters with antiseptic coating were safe and had l ess risk of colonization of bacteria and fungi than standard catheters in t he critically ill patients. (C) 2000 Elsevier Science Inc. All rights reser ved.