Effect of central venous catheter type on infections: a prospective clinical trial.
This study reports on a block clinical trial of two types of central venous catheters (CVCS): antiseptic-impregnated catheters (AIC) and non-impregnated catheters (non-AIC), on catheter tip colonization and bacteraemia. In total, 500 catheters were inserted in 390 patients over the 18 month study period, 260 (52.0%) AIC and 240 (48.0%) non-AIC. Of these, 460 (92.0%) tips (237 AIC and 223 non-AIC) were collected. While significantly fewer AIC, 14 (5.9%), than non-AIC, 30 (13.5%), catheters were colonized (P<0.01), there was no difference in the rates of bacteraemias in the two groups (0.8% vs. 2.7%, respectively, P=0.16). There were 6.87 (95% CI 3.38-14.26) and 16.92 (95% CI 10.61-27.12) colonized AIC and non-AIC catheters, respectively, per 1000 catheter days, a difference that was significant (P<0.01). However, no difference emerged between bacteraemias in AIC and non-AIC catheters per 1000 catheter days measured at 0.98 (95% CI 0.24-5.54) and 3.38 (95% CI 1.29-9.34), respectively (P=0.10). Of the 444 CVCs that were sited in the subclavian or jugular veins and had tips collected, significantly more catheters were colonized in the jugular group, 19 (20%), compared with the subclavian group, 24 (6.9%; P< or =0.01). Overall, the low rates of colonization and bacteraemia may be explained by the population studied, the policies used and the employment of a clinical nurse dedicated to CVC management.
Richards
B
B
Intensive Care Unit, Gold Coast Hospital, Southport, Qld, Australia.
Chaboyer
W
W
Bladen
T
T
Schluter
P J
PJ
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology*; D002710:Chlorhexidine / Q000008:administration & dosage; D020099:Coated Materials, Biocompatible; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D004866:Equipment Contamination / Q000517:prevention & control; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D017053:Infection Control / Q000379:methods; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011793:Queensland; D012837:Silver Sulfadiazine / Q000008:administration & dosage; D013350:Subclavian Vein
D000891:Anti-Infective Agents, Local; D020099:Coated Materials, Biocompatible; D002710:Chlorhexidine; D012837:Silver Sulfadiazine