title: Chlorhexidine and silver-sulfadiazine coated central venous catheters in haematological patients--a double-blind, randomised, prospective, controlled trial.
abstract: BACKGROUND
  Central venous catheters (CVCs) are essential for the intensive care of patients with haematological illness. Catheter-related infections (CRI) are an important problem in modern medicine, which may lead to life-threatening situations, to prolonged hospitalisation and increased cost. In immunocompromised patients suffering from haemato-oncological diseases, CRI is a significant factor for adverse outcome. Several clinical studies have shown that CVCs coated with antiseptics such as chlorhexidine and silver-sulfadiazine (CHSS) reduce the risk of catheter-related bacteraemia. Most studies, however, were performed on intensive care patients not suffering from chemotherapy-induced immunosuppression.
  
  
  METHODS
  A prospective double-blind, randomised, controlled trial was performed to investigate the effectiveness of CHSS-coated catheters in haemato-oncological patients. A total number of 184 catheters (median duration of placement, 11 days) were inserted into 184 patients (male 115, female 69), of which 90 were antiseptically coated. After removal, all catheters were investigated for bacterial growth.
  
  
  RESULTS
  Catheters coated with CHSS were effective in reducing the rate of significant bacterial growth on either the tip or subcutaneous segment (26%) compared to control catheters (49%). The incidence of catheter colonisation was also significantly reduced (12% coated vs 33% uncoated). Data obtained show a significant reduction of catheter colonisation in CHSS catheters. There was no significant difference in the incidence of catheter-related bacteraemia (3% coated vs 7% uncoated). However, due to the overall low rate of CRI, we could not observe a significant reduction in the incidence of catheter-related bacteraemia.
  
  
  CONCLUSIONS
  Our data show that the use of CHSS catheters in patients with haematological malignancy reduces the overall risk of catheter colonisation and CRI, although the incidence of catheter-related bacteremia was similar in both groups.
authors.affiliation: Department of Internal Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Torben
authors.initials: T
authors.lastname: Ostendorf
authors.forename: Andrea
authors.initials: A
authors.lastname: Meinhold
authors.forename: Christoph
authors.initials: C
authors.lastname: Harter
authors.forename: Hans
authors.initials: H
authors.lastname: Salwender
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Egerer
authors.forename: Heinrich K
authors.initials: HK
authors.lastname: Geiss
authors.forename: Antony D
authors.initials: AD
authors.lastname: Ho
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
mesh_terms: D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002710:Chlorhexidine; D004311:Double-Blind Method; D005260:Female; D005858:Germany; D019337:Hematologic Neoplasms; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012837:Silver Sulfadiazine
chemical_list: D002710:Chlorhexidine; D012837:Silver Sulfadiazine