title: Reduced intravascular catheter-related infection by routine use of antibiotic-bonded catheters in a surgical intensive care unit.
abstract: We report a comparative analysis of intravascular catheter-related infection before and after routine use of antibiotic-bonded catheters in an intensive care unit. Cefazolin-bonded catheters were placed in patients requiring catheterization for at least 3 days, or with remote infection, standard catheters at other times. One thousand forty-five catheters (259 patients) over 6 months were compared with 801 (236 antibiotic-bonded, 565 standard) catheters (239 patients) the next 6 months. After use of antibiotic-bonded catheters, we found: 1.7% catheters infected versus 3.7% (p = 0.01); catheter-associated bacteremia 0.1% versus 1.3% (p < 0.005); catheter-related infection rate 4.39 versus 10.73 per 1000 patient days (p < 0.005), and 5.06 versus 11.47 per 1000 catheter days (p < 0.01); and cumulative risk of infection decreased (p < 0.005). Antibiotic-bonded catheters were used with more remote infections (52% versus 27%, p < 0.001), had longer indwelling time (4.4 versus 3.1 days, p = 0.0001), and more were inserted over a guide wire (66% vs. 28%, p < 0.001). In conclusion routine use of antibiotic-bonded catheters was associated with a significant reduction in infectious complications.
authors.affiliation: Department of Anesthesia, University of Iowa College of Medicine, Iowa City, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Kamal
authors.forename: D
authors.initials: D
authors.lastname: Divishek
authors.forename: G C
authors.initials: GC
authors.lastname: Kumar
authors.forename: B R
authors.initials: BR
authors.lastname: Porter
authors.forename: D J
authors.initials: DJ
authors.lastname: Tatman
authors.forename: J R
authors.initials: JR
authors.lastname: Adams
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002437:Cefazolin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin