title: [A prospective randomized controlled trial on effect of norvancomycin tube sealing for prevention of central venous catheter-related infection in critical patients].
abstract: OBJECTIVE
  To evaluate the clinical value of tube-sealing with norvancomycin and heparin saline mixture for prevention of central venous catheter-related infection (CRI).
  
  
  METHODS
  A prospective randomized controlled trial was performed. 120 patients who were admitted to department of critical care medicine from January 2012 to January 2014 were included, with their subclavian vein catheterization installation time longer than 48 hours, age over 18 years and younger than 80 years, and acute physiology and chronic health evaluation II (APACHE II) score reaching 10-29. The patients were divided into two groups using a random number table, and finally 116 patients were enrolled. Norvancomycin and heparin saline mixture were used for tube sealing in the intervention group (n=56), while only heparin saline was used in the control group (n=60). The incidence of CRI, catheter correlated spectrum of pathogens, adverse events, mortality, hospital day, catheter retention time, and hospital costs were compared between two groups.
  
  
  RESULTS
  (1) There was no significant difference in the incidence of CRI between intervention group and control group [7.14% (4/56) vs. 8.33% (5/60), χ(2)=0.058, P=1.000]. There was no catheter pathogenic colonization in the intervention group, but there were 2 cases of catheter pathogenic colonization in control group. (2) A total of 7 pathogens were found in two groups. Three cases with pathogenic bacteria was found in the intervention group, with 1 case of Pseudomonas aeruginosa, 1 case Acinetobacter baumannii, and 1 case fungi. Staphylococcus aureus, Staphylococcus epidermidis, fungi, and Acinetobacter baumannii was found in the control group, with 1 case of each. There was no significantly statistical difference between two groups (all P>0.05), but there was a decreasing trend of Gram-positive cocci infection in the intervention group. (3) There was no significant difference in the catheter thrombosis, local bleeding or hematoma, catheter dislocation and other adverse events between intervention group and control group [21.43% (12/56) vs. 23.33% (14/60), χ(2)=0.060, P=0.806]. (4) There were no significant differences in mortality [7.14% (4/56) vs. 8.33% (5/60), χ(2)=0.058, P=1.000], hospital day (35.9±15.2 days vs. 34.1±16.3 days, t=16.330, P=0.620), catheter retention time (25.0±4.5 days vs. 24.5±5.1 days, t=26.427, P=2.560) and cost of hospitalization (10 thousand Yuan: 3.42±1.22 vs. 3.72±1.30, t=13.215, P=1.560) between intervention group and control group.
  
  
  CONCLUSIONS
  For patients with central venous catheter, application norvancomycin with heparin saline mixture for tube sealing did not reduce the incidence of CRI, the incidence of adverse events and mortality, does not reduce hospitalization time, catheter retention time and hospital costs, but may reduce the catheter colonization and infection of Gram-positive bacteria.
authors.affiliation: Department of Critical Care Medicine, Harrison International Peace Hospital, Hengshui 053000, Hebei, China. Corresponding author: Liu Shuhong, Email: lsh205215@aliyun.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Zhaobo
authors.initials: Z
authors.lastname: Cui
authors.forename: Jinrong
authors.initials: J
authors.lastname: Wang
authors.forename: Zhenjie
authors.initials: Z
authors.lastname: Hu
authors.forename: Hongshan
authors.initials: H
authors.lastname: Kang
authors.forename: Jinfang
authors.initials: J
authors.lastname: Ji
authors.forename: Shuhong
authors.initials: S
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014640:Vancomycin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014640:Vancomycin; C511195:norvancomycin