Chlorhexidine-silver sulfadiazine-impregnated venous catheters are efficient even at subclavian sites without tracheostomy

Lorente, Leonardo; Lecuona, Marı́a; Jiménez, Alejandro; Cabrera, Judith; Santacreu, Ruth; Lorenzo, L; Raja, Lorena; Mora, María L.

doi:10.1016/j.ajic.2016.04.236

Cited by 4 publications

(8 citation statements)

References 24 publications

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“…; Lorente et al . ). Two systematic reviews evaluating randomized controlled trials (RCTs) found an overall significant difference between antimicrobial‐impregnated and standard CVCs in the rates of catheter colonization and catheter‐related bloodstream infection (CRBI) (Lai et al .…”

Section: Discussionmentioning

confidence: 97%

“…It is important to highlight that in vivo and in vitro studies are different models to study biofilm physiology and both have progressively contributed to the current knowledge of this field. Clinical and in vitro studies have demonstrated that antimicrobial-impregnated devices are effective (O'Grady et al 2011;Naparstek et al 2014), although their efficiency and durability against various micro-organisms, especially multidrug-resistant bacteria and to biofilm, are scarcely discussed (Jamal et al 2014a;Lorente et al 2016). Two systematic reviews evaluating randomized controlled trials (RCTs) found an overall significant difference between antimicrobial-impregnated and standard CVCs in the rates of catheter colonization and catheter-related bloodstream infection (CRBI) (Lai et al 2016;Wang et al 2018).…”

Section: Discussionmentioning

confidence: 99%

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In vitro activity of antimicrobial‐impregnated catheters against biofilms formed by KPC‐producing Klebsiella pneumoniae

et al. 2019

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Aim To evaluate the activity and effectiveness of impregnated central venous catheters (CVC) against Klebsiella pneumoniae biofilms. Methods and Results The antimicrobial activity and durability of impregnated‐CVCs were evaluated over time and the size of zones of inhibition (ZI) was measured. Biofilm formation was observed by quantitative culture and also by scanning electron microscopy. The catheters impregnated with chlorhexidine/silver sulfadiazine (CHX/SS) reduced bacteria counts by 0·3 log and were most effective (P < 0·01) against Klebsiella pneumoniae biofilms N‐acetylcysteine/levofloxacin (NAC/LEV) catheters. It was observed that the catheter impregnated with NAC/LEV had initially the largest average ZI size being statistically significant (P < 0·01). The NAC/LEV combination remained active until day 30, whereas the combination of CHX/SS was completely inactivated from day 15 on. Conclusions The NAC/LEV combination showed greater durability on the catheters, but it was the CHX/SS combination that had the greater initial efficacy in bacterial inhibition. It was also observed that NAC/LEV‐impregnated catheters do not prevent the emergence of resistant subpopulations inside the inhibition halos during antimicrobial susceptibility tests. Significance and Impact of the Study Our results highlighted that the in vitro efficacy of antimicrobial‐impregnated CVCs is limited by time and that their colonization occurred earlier than expected. Our data also demonstrated that NAC/LEV remained active until day 30 of evaluation and CHX/SS combination was completely inactivated from day 15 on. Our findings suggested that implantable devices should be carefully used by medical community.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

In vitro activity of antimicrobial‐impregnated catheters against biofilms formed by KPC‐producing Klebsiella pneumoniae

et al. 2019

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“…Several clinical studies have demonstrated CRBSI reduction with chlorhexidine-treated PICCs and CICCs. [19][20][21][22][23] Chlorhexidine-treated PICCs (CH-PICCs) have also been shown to lessen catheter-related thrombus also demonstrating anti-thrombogenic effectiveness when challenged with Gram-positive bacterial infection in a similar ovine model. 24 Chlorhexidine minimizes thrombus accumulation on catheter surfaces by the inhibition of thrombin, which in turn inhibits the final step in the clotting cascade pathway, that is, the conversion of fibrinogen to a fibrin clot.…”

Section: Introductionmentioning

confidence: 99%

Chlorhexidine-coated peripherally inserted central catheters reduce fibroblastic sleeve formation in an in vivo ovine model

et al. 2018

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“…These were prompted by the Michigan Keystone project published in 2006 by Pronovost [40]. These measures included maximum sterile barrier precautions, aseptic insertion technique, chlorhexidine skin preparation, transparent dressings, and removal of the catheter as soon as clinically possible [40][41][42]. It was also determined that the routine exchange of catheters for infection prevention was not necessary and may cause contamination [40,42].…”

Section: Central Line-associated Bloodstream Infections (Clabsi)mentioning

confidence: 99%

“…The increased interest and financial considerations have also led to device innovations for infection reduction. These include alcohol impregnated caps for the covering of hubs, and the development of antimicrobial-impregnated CVC with both internal and external surface impregnation [41,42].…”

Section: Central Line-associated Bloodstream Infections (Clabsi)mentioning

confidence: 99%

Bedside Procedure: Retained Central Venous Catheter

Cheung¹,

Mellert²,

Firstenberg³

2018

Vignettes in Patient Safety - Volume 2

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The placement of central venous catheters (CVC) is a common medical procedure and adjunct to current medical therapy. With millions of CVC placed yearly in the United States, complications occur. It is important to be aware of the potential immediate and long term complications associated with this procedure. In this chapter, a representative case of retained CVC guidewire is presented. Provider experience, appropriate patient selection and insertion technique can minimize the risk of immediate complication in most cases. A brief discussion of CVC complications with emphasis on guidewire malfunction is presented along with management and retrieval options.

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Chlorhexidine-silver sulfadiazine-impregnated venous catheters are efficient even at subclavian sites without tracheostomy

Cited by 4 publications

References 24 publications

In vitro activity of antimicrobial‐impregnated catheters against biofilms formed by KPC‐producing Klebsiella pneumoniae

In vitro activity of antimicrobial‐impregnated catheters against biofilms formed by KPC‐producing Klebsiella pneumoniae

Chlorhexidine-coated peripherally inserted central catheters reduce fibroblastic sleeve formation in an in vivo ovine model

Bedside Procedure: Retained Central Venous Catheter

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