title: Can a new antiseptic agent reduce the bacterial colonization rate of central venous lines in post-cardiac surgery patients?
abstract: BACKGROUND
  Central venous (CV) catheters play an essential role in the management of critically ill patients in the Intensive Care Unit (ICU). CV lines are, however, allied to catheter-associated blood stream infections. Bacterial colonization of CV lines is deemed the main cause of catheter-associated infection. The purpose of our study was to compare bacterial colony counts in the catheter site before CV line insertion in two groups of post-cardiac surgery patients: a group receiving Sanosil (an antiseptic agent composed of H2O2 and silver) and a control group.
  
  
  METHODS
  This interventional prospective double-blinded clinical trial recruited the patients in three post-cardiac surgery ICUs of a heart center. The participants were divided into interventional (113 patients) and control (136 patients) groups. Sanosil was added to the routine preparation procedure (Chlorhexidine bath one day before and scrub with Povidone-Iodine just before the CV line insertion). After the removal of the CV lines, the catheters tips were sent for culture and evaluation of colony counts.
  
  
  RESULTS
  Catheter colonization occurred in 55 (22.1%) patients: 26 (23%) patients in the Sanosil group and 29 (21.3%) in the control group; there was no significant statistical difference between the two groups (p value = 0.75, RR = 1.05, 95% CI: 0.76-1.45). The most common organism having colonized in the cultures of the catheter tips was staphylococcus epidermis: 20 cases in the control group and 16 cases in the intervention group.
  
  
  CONCLUSIONS
  Catheter colonization frequently occurs in post-cardiac surgery patients. However, our results did not indicate the effectiveness of adding Sanosil to the routine preparation procedure with respect to reducing catheter bacterial colonization.
authors: Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Fardin
authors: F
authors: Yousefshahi
authors: Khashayar
authors: K
authors: Azimpour
authors: Mohammad Ali
authors: MA
authors: Boroumand
authors: Mahdi
authors: M
authors: Najafi
authors: Khosro
authors: K
authors: Barkhordari
authors: Mitra
authors: M
authors: Vaezi
authors: Nahid
authors: N
authors: Rouhipour
keywords: Anti-infective agents, local; Central venous catheters; Infection
references: Appl Environ Microbiol. 2008 Apr;74(7):2171-8
references: 18245232
references: Int J Health Care Qual Assur. 2010;23(6):583-90
references: 20845824
references: Br Med J. 1972 Jan 15;1(5793):136-40
references: 5007838
references: Arch Surg. 1997 Dec;132(12):1348-51
references: 9403542
references: Ann Agric Environ Med. 2003;10(2):151-7
references: 14677905
references: Arch Surg. 1996 Sep;131(9):986-9
references: 8790170
references: J Biomed Mater Res. 2000 Dec 15;52(4):662-8
references: 11033548
references: Am Surg. 1996 Aug;62(8):641-6
references: 8712561
references: Anaesth Intensive Care. 1997 Dec;25(6):637-9
references: 9452845
references: Semin Respir Infect. 2000 Dec;15(4):264-71
references: 11220408
references: JAMA. 1999 Jan 20;281(3):261-7
references: 9918482
references: Int J Antimicrob Agents. 2000 Oct;16(2):165-8
references: 11053802
references: J Antimicrob Chemother. 1994 May;33(5):969-78
references: 8089070
references: Infect Control Hosp Epidemiol. 1994 Apr;15(4 Pt 1):227-30
references: 8207188
references: Ann Intern Med. 1997 Aug 15;127(4):257-66
references: 9265424
references: Anaesthesia. 1999 Sep;54(9):868-72
references: 10460558
references: J Hosp Infect. 1997 Oct;37(2):145-56
references: 9364263
references: Appl Environ Microbiol. 2003 Jun;69(6):3327-32
references: 12788733
references: Arch Intern Med. 1999 Jul 12;159(13):1437-44
references: 10399895
references: Zentralbl Bakteriol Mikrobiol Hyg B. 1986 Jul;182(4):381-92
references: 3022501
references: Eur J Anaesthesiol. 1997 Jul;14(4):428-31
references: 9253572
references: Anaesth Intensive Care. 1996 Jun;24(3):330-3
references: 8805887
references: J Am Dent Assoc. 2001 Sep;132(9):1287-91
references: 11665356
references: Crit Care Med. 1996 Oct;24(10):1660-5
references: 8874302
references: Lancet. 1991 Aug 10;338(8763):339-43
references: 1677698
references: Nephron. 2002 Jul;91(3):399-405
references: 12119469