title: Impact of oligon central venous catheters on catheter colonization and catheter-related bloodstream infection.
abstract: OBJECTIVE
  To evaluate a new antimicrobial treatment for central venous catheters in comparison with a traditional treatment, by assessing the catheter colonization and catheter-related bloodstream infection rates in two groups of patients.
  
  
  METHODS
  Multiple-center, prospective randomized study.
  
  
  METHODS
  The medical and surgical departments of ten institutions.
  
  
  METHODS
  Patients requiring a central venous catheter for medical or surgical pathologies between June 2000 and November 2001.
  
  
  METHODS
  Patients in the control group received a conventional benzalkonium-treated double-lumen central venous catheter, while patients in the oligon group received an oligon-treated (polyurethane combined with silver, carbon, and platinum) catheter with the same characteristics. Data collection included demographics, preexisting clinical conditions, main pathology, catheter insertion, and management data. Catheter colonization was defined as the growth of > or = 15 colony-forming units in culture of catheter segments by the roll-plate method, or > or = 1000 colony-forming units for the sonication method, and catheter-related bloodstream infection was defined as isolation of the same organism from the colonized catheter and from the peripheral blood of a patient with clinical signs of bloodstream infection.
  
  
  RESULTS
  Data were obtained from 545 catheters. Of these, 132 catheters (24.2%) were positive for colonization. Patients in the oligon group demonstrated a lower risk for catheter colonization in the overall population (relative risk, 0.63; 95% confidence interval, 0.46-0.86; p = .003) and in the surgical subgroup (relative risk, 0.5; 95% confidence interval, 0.33-0.76;p = .001). Significant differences between groups were detected for coagulase-negative staphylococci and Gram-negative bacilli colonization rates. Twenty-one patients (3.8%) were positive for catheter-related bloodstream infection, without significant differences between control and oligon groups.
  
  
  CONCLUSIONS
  Oligon treatment is effective in limiting the catheter colonization rate. Due to the limited amount of events, this study lacked the power to detect significant differences in terms of catheter-related bloodstream infection rate.
authors.affiliation: Department of Cardiothoracic Anesthesia, Istituto Policlinico S. Donato, Milan, Italy. cardioanestesia@virgillo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Ranucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Isgrò
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Giomarelli
authors.forename: Marco
authors.initials: M
authors.lastname: Pavesi
authors.forename: Aldo
authors.initials: A
authors.lastname: Luzzani
authors.forename: Iolter
authors.initials: I
authors.lastname: Cattabriga
authors.forename: Manuela
authors.initials: M
authors.lastname: Carli
authors.forename: Paolo
authors.initials: P
authors.lastname: Giomi
authors.forename: Antonio
authors.initials: A
authors.lastname: Compostella
authors.forename: Antonio
authors.initials: A
authors.lastname: Digito
authors.forename: Valerio
authors.initials: V
authors.lastname: Mangani
authors.forename: Vito
authors.initials: V
authors.lastname: Silvestri
authors.forename: Enzo
authors.initials: E
authors.lastname: Mondelli
mesh_terms: D000206:Actuarial Analysis; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology; D015169:Colony Count, Microbial; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011140:Polyurethanes; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D018030:Silver Compounds
chemical_list: D000890:Anti-Infective Agents; D011140:Polyurethanes; D018030:Silver Compounds