Antiseptic‐bonded central venous catheters and bacterial colonisation

Abstract

This study was undertaken to evaluate the impact of chlorhexidine/silver sulphadiazine-bonded catheters on the incidence of colonisation and catheter-related sepsis in critically ill patients. Threehundred and fifty-one catheters were inserted into 228 patients during the study period, 174chlorhexidine/silver sulphadiazine-bonded catheters and 177 standard catheters. Indications for catheter removal were: death, clinical redundancy and clinical evidence of local or systemic infection. All catheter tips were sent to the microbiology laboratory for semiquantitative analysis of bacterial colony count. Seventy-one (40.2%) of the standard catheters and 47 (27.2%) of the antiseptic-bonded catheters were found to be colonised on removal (p < 0.01). Eight cases (4.7%) of catheter-related sepsis were associated with standard catheters and three cases (1.7%) with antiseptic-bonded catheters, however, this reduction was not statistically significant. Our results indicate that the use of antiseptic-bonded catheters in critically ill patients significantly reduces the incidence of bacterial colonisation.

Central venous catheter-related bloodstream infection caused by Staphylococcus aureus: microbiology and risk factors

“…A series of studies published in the 90's investigating CVCs that were not soaked with antimicrobial antiseptic gave a variation of the colonization rate for these catheters of from 23.6% to 52.2% in patients in ICUs [14][15][16][23][24][25]. In our study the colonization rate of CVCs was lower (21.2%).…”

“…The proportion of CB-BSIs varies from 2.5% to 6.4% [13][14][15][16], with rates corresponding to 2.4-12.0 episodes per 1,000 days/CVC [17][18][19][20][21][22]. We found a rate of 2.2%, or 4.9 episodes per 1,000 days/catheter, among patients that were not in the intensive-care unit (ICU).…”

The clinical effectiveness and cost-effectiveness of central venous catheters treated with anti-infective agents in preventing bloodstream infections: a systematic review and economic evaluation

“…These measures are surrogate indicators of the clinical effectiveness of the catheters in preventing CRBSI; colonisation on its own may simply reflect contamination of the catheter by entry-site flora during removal. This is likely to be the case in studies where the rates of colonisation are considerably higher than the rates of CRBSI; for example, Hannan,63 where the standard rate of CRBSI is 2%, but their standard rate of colonisation was 40%, and Yücel 9 (CRBSI = 1%, colonisation = 36-39%). This contamination may explain the heterogeneity of the reported rates of colonisation.…”

Staphylococcus epidermidis biofilms: importance and implications

“…Strategies to develop biomaterials with resistance to bacterial colonisation focus on achieving an optimum concentration of the antimicrobial agent in the biomaterial in order to deliver either a short-term high-concentration or a long-term constant concentration of the particular agent. The effectiveness of silver and silver-antibiotic combinations, incorporated into a range of biomaterials, against the development of S. epidemidis bio®lms has been demonstrated in vitro [67], in animal models [68,69] and in clinical trials [70]. In addition to reducing the rate of infection, the use of antiseptic-impregnated catheters has economic bene®ts and can signi®cantly reduce hospitalisation costs [71].…”