title: [Prevention of catheter-related infection: usefulness and cost-effectiveness of antiseptic catheters in children].
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of the antiseptic-impregnated catheter compared with conventional catheters in preventing catheter- related blood stream infections (CR-BSI).
  
  
  METHODS
  Cost-effectiveness analysis; clinical trial, experimental, randomized, controlled, prospective, open label. Patients and methods. A 172 patient cohort, under 1-year-old or less than 10 kg, postoperative cardiovascular children with central venous catheters (CVC) admitted to Cardiac Intensive Care Unit (UCI 35) at Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan", since September 2005 to December 2007. Demographic and CVC data were retrieved to compare: age, gender, weight, diagnosis, surgery, CVC days, costs and complications. Intervention. CVC Arrow, double-lumen, > 48 h of duration; intervention group: antiseptic-impregnated CVC vs. control group: CVC without antiseptics (conventional).
  
  
  RESULTS
  The incidence of CR-IE (CR-Infected Events: colonization, local infection and/or CRBSI; combined end point) was 27% for antiseptic- impregnated CVC vs. 31% for conventional catheters (p= 0.6) with similar accumulated incidence of CR- BSI: 2.8 vs. 3.3 per 1000 dayscatheter. We found no differences between groups, except in weight: median 4.0 kg (r 2-17) vs. 4.7 kg (r 2-9) p= 0.0002 and age, median 2 months (r 1- 48) vs. 5 months (r 1- 24) p= 0.0019 in antiseptic-impregnated CVC group. These differences, though statistically significant were clinically non relevant. Median cost per patient during intensive care stay in the conventional CVC group was $3.417 (359-9.453) and in the antiseptic-impregnated-CVC group was $4.962 (239-24.532), p= 0.10.
  
  
  CONCLUSIONS
  The use of antiseptic-impregnated CVC compared with conventional CVC did not decrease CR-BSI in this population. The cost per patients was higher in the antiseptic impregnated CVC group. These results do not support the routine use of this type of CVC in our population.
authors.affiliation: Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina. lenzanamiriam@gmail.com
authors.forename: Ana M
authors.initials: AM
authors.lastname: Lenz
authors.forename: Juan C
authors.initials: JC
authors.lastname: Vassallo
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Moreno
authors.forename: María
authors.initials: M
authors.lastname: Althabe
authors.forename: Silvia
authors.initials: S
authors.lastname: Gómez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Magliola
authors.forename: Lidia
authors.initials: L
authors.lastname: Casimir
authors.forename: Rosa
authors.initials: R
authors.lastname: Bologna
authors.forename: Jorge
authors.initials: J
authors.lastname: Barretta
authors.forename: Pablo
authors.initials: P
authors.lastname: Ruffa
mesh_terms: D000891:Anti-Infective Agents, Local; D055499:Catheter-Related Infections / Q000191:economics* / Q000517:prevention & control*; D002404:Catheterization / Q000191:economics*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies
chemical_list: D000891:Anti-Infective Agents, Local