Reduction of catheter-related infections in neutropenic patients: a prospective controlled randomized trial using a chlorhexidine and silver sulfadiazine-impregnated central venous catheter

Jaeger, K.; Zenz, Sebastian; Jüttner, Björn; Ruschulte, Heiner; Kuse, E. R.; Heine, J.; Piepenbrock, S.; Ganser, Arnold; Karthaus, Meinolf

doi:10.1007/s00277-004-0972-6

Cited by 50 publications

(21 citation statements)

References 27 publications

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“…Those patients treated with BioPatch® had a significantly lower rate of CRI (p=0.016). This could be achieved in a highly elaborated setting with a strictly sterile puncture technique and impregnated catheters, the use of which being a consequence from a former study of our group [3].…”

Section: Discussionmentioning

confidence: 99%

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Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

et al. 2008

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The objective of the study was to evaluate the effectiveness of chlorhexidine-impregnated sponges for reducing catheter-related infections of central venous catheters inserted for cancer chemotherapy. The method used was a randomized, prospective, open, controlled clinical study (three-step group sequential analysis protocol). The patients were from two high dependency units at a university hospital undergoing chemotherapy for haematological or oncological malignancies requiring central venous catheters (CVCs) expected to remain in place for at least 5 days. Six hundred and one patients with 9,731 catheterization days were studied between January 2004 and January 2006. Patients admitted for chemotherapy received chlorhexidine and silver sulfadiazine-impregnated triple-lumen CVCs under standardized conditions and were randomized to the groups receiving a chlorhexidine gluconate-impregnated wound dressing or a standard sterile dressing. Daily routine included clinical assessment of the insertion site (swelling, pain, redness), temperature, white blood count and C-reactive protein. Catheters remained in place until they were no longer needed or when a CVCrelated infection was suspected. Infection was confirmed with blood cultures via the catheter lumina and peripheral blood cultures according to the time-to-positivity method. Six hundred and one patients were included. The groups were comparable with respect to demographic and clinical data. The incidence of CVC-related infections were 11.3% (34 of 301) and 6.3% (19 of 300) in the control and chlorhexidine-impregnated wound dressing groups, respectively (p=0.016, relative risk 0.54; confidence interval 0.31-0.94). Especially, catheter-related infections at internal jugular vein insertions could be reduced (p=0.018). No adverse effects related to the intervention were observed. The use of chlorhexidine-impregnated wound dressings significantly reduced the incidence of CVC-related infections in patients receiving chemotherapy.

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Section: Discussionmentioning

confidence: 99%

“…In immunocompromised patients, the use of antibioticimpregnated catheters helps to further reduce CVC-related infections [3,4]; consequently, we use only impregnated catheters in haematology and oncology patients.…”

Section: Introductionmentioning

confidence: 99%

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

et al. 2008

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“…Again there are a number of studies in which the silver coated catheters are compared to their antibiotic-loaded or non-coated counterparts. However, there are many studies that confirm the antibiotic effect of catheter silver coatings, which reduce surface colonization and CBSI [100][101][102]. However some studies report the reduction of surface colonization without a direct significant effect on CBSI [103].…”

Section: Medical Coatings Containing Silver or Silver Nanoparticlesmentioning

confidence: 99%

New Strategies in the Development of Antimicrobial Coatings: The Example of Increasing Usage of Silver and Silver Nanoparticles

2011

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Bacterial infection from medical devices is a major problem and accounts for an increasing number of deaths as well as high medical costs. Many different strategies have been developed to decrease the incidence of medical device related infection. One way to prevent infection is by modifying the surface of the devices in such a way that no bacterial adhesion can occur. This requires modification of the complete surface with, mostly, hydrophilic polymeric surface coatings. These materials are designed to be non-fouling, meaning that protein adsorption and subsequent microbial adhesion are minimized. Incorporation of antimicrobial agents in the bulk material or as a surface coating has been considered a viable alternative for systemic application of antibiotics. However, the manifestation of more and more multi-drug resistant bacterial strains restrains the use of antibiotics in a preventive strategy. The application of silver nanoparticles on the surface of medical devices has been used to prevent bacterial adhesion and subsequent biofilm formation. The nanoparticles are either deposited directly on the device surface, or applied in a polymeric surface coating. The silver is slowly released from the surface, thereby killing the bacteria present near the surface. In the last decade there has been a surplus of studies applying the concept of silver nanoparticles as an antimicrobial agent on a range of different medical devices. The main problem however is that the exact antimicrobial mechanism of silver remains unclear. Additionally, the antimicrobial efficacy of silver on OPEN ACCESSPolymers 2011, 3 341 medical devices varies to a great extent. Here we will review existing antimicrobial coating strategies and discuss the use of silver or silver nanoparticles on surfaces that are designed to prevent medical device related infections.

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“…By July 2005 a further 11 trials had been published. [8][9][10][11][12][13][14][15][16][17][18] This review was commissioned to determine the clinical effectiveness and cost-effectiveness of CVCs treated with anti-infective agents (AI-CVCs).…”

Section: Introductionmentioning

confidence: 99%

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

Hockenhull¹,

Dwan²,

Boland³

et al. 2008

Health Technol Assess

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Reduction of catheter-related infections in neutropenic patients: a prospective controlled randomized trial using a chlorhexidine and silver sulfadiazine-impregnated central venous catheter

Cited by 50 publications

References 27 publications

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

New Strategies in the Development of Antimicrobial Coatings: The Example of Increasing Usage of Silver and Silver Nanoparticles

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

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