title: Chlorhexidine-silver sulfadiazine-impregnated venous catheters save costs.
abstract: BACKGROUND
  Previous cost-effectiveness analyses have found that the use of chlorhexidine-silver sulfadiazine (CHSS)-impregnated catheters is associated with decreased catheter-related bloodstream infections (CRBSI) and central venous catheter (CVC)-related costs. However, in these analyses, the CVC-related cost included the increase of hospital stay.
  
  
  OBJECTIVE
  Our aim was to determine the immediate CVC-related cost (including only the cost of CVC, diagnosis of CRBSI, and antimicrobials for the treatment of CRBSI) of using a CHSS or a standard catheter in internal jugular venous access.
  
  
  METHODS
  We performed a prospective, observational, cohort study of patients admitted to the intensive care unit (ICU), Hospital Universitario de Canarias (Tenerife, Spain), who received 1 or more internal jugular venous catheters.
  
  
  RESULTS
  The study included 245 CHSS-impregnated catheters and 391 standard catheters. Exact logistic regression analysis showed that CHSS-impregnated catheters were associated with a lower incidence of CRBSI, controlling for catheter duration, than standard catheters (0 vs 5.04 CRBSI per 1,000 catheter-days, respectively; odds ratio, 0.80; 95% confidence interval: 0.712-0.898; P < .001). Poisson regression showed that CHSS-impregnated catheters were associated with lower CVC-related cost per day than standard catheters (€3.78 ± €4.45 vs €7.28 ± €16.71, respectively; odds ratio, 0.52; 95% confidence interval: 0.504-0.535; P < .001). Survival analysis showed that CHSS-impregnated catheters were associated with increased CRBSI-free time compared with standard catheters (χ(2) = 14.9; P < .001).
  
  
  CONCLUSIONS
  The use of CHSS-impregnated catheters reduced the incidence of CRBSI and immediate CVC-related costs in the internal jugular venous access.
authors.affiliation: Department of Critical Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. Electronic address: lorentemartin@msn.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lorente
authors.affiliation: Department of Microbiology and Infection Control, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Lecuona
authors.affiliation: Research Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jiménez
authors.affiliation: Department of Critical Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Santacreu
authors.affiliation: Department of Critical Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Lorena
authors.initials: L
authors.lastname: Raja
authors.affiliation: Department of Critical Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Oswaldo
authors.initials: O
authors.lastname: Gonzalez
authors.affiliation: Department of Critical Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: María L
authors.initials: ML
authors.lastname: Mora
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D002404:Catheterization / Q000191:economics / Q000379:methods*; D057785:Catheters / Q000191:economics*; D002710:Chlorhexidine / Q000008:administration & dosage*; D015331:Cohort Studies; D004202:Disinfectants / Q000008:administration & dosage*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D012837:Silver Sulfadiazine / Q000008:administration & dosage*; D013030:Spain / Q000453:epidemiology
chemical_list: D004202:Disinfectants; D002710:Chlorhexidine; D012837:Silver Sulfadiazine
keywords: Bacteremia; Coated; Effectiveness; Efficiency; Venous