title: High incidence of line-related infection and mechanical failure of an antiseptic impregnated central venous catheter in highly immunocompromised patients.
abstract: Prolonged central venous catheterisation is associated with a substantial risk of line related infection, which may be reduced when a chlorhexidine/silver-sulfadiazine coated catheter (ARROWgard Blue(TM)) is used in medical or surgical ICU patients. However, no data is available from severely immunocompromised patients. We therefore performed an initial exploratory study among patients with haematological malignancy, aplastic anaemia or bone marrow transplantation. The study was terminated after the 12th catheter insertion. Eight of 11 assessable catheters developed a notable degree of mechanical dysfunction, which directly led to catheter removal in 2 patients. Six of the 11 catheters were unstable. Catheter-related infection occurred in 5 instances. Only 1 catheter functioned normally and was unassociated with infection. The ARROWgard Blue(TM) catheter cannot be recommended for prolonged use in these patients.
authors.affiliation: Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
authors.forename: M E
authors.initials: ME
authors.lastname: Ellis
authors.forename: D
authors.initials: D
authors.lastname: Rhydderch
authors.forename: F
authors.initials: F
authors.lastname: Zwaan
authors.forename: M L
authors.initials: ML
authors.lastname: Guy
authors.forename: F
authors.initials: F
authors.lastname: Baillie
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001424:Bacterial Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002710:Chlorhexidine / Q000494:pharmacology; D004868:Equipment Failure; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D012837:Silver Sulfadiazine / Q000494:pharmacology
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine; D012837:Silver Sulfadiazine