+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia



Influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia



Archives of Internal Medicine 158(1): 81-87



Objective: To evaluate the efficacy of triple-lumen central venous catheters coated with a combination product of chlorhexidine and silver sulfadiazine (CSS) in reducing the incidence of local catheter infection and catheter-related bacteremia. Design: Randomized, controlled trial. Setting: The surgical intensive care units in a university hospital. Patients: All patients who needed central venous catheterization were randomized to receive either an uncoated triple-lumen catheter (n=57) or a catheter coated with CSS (n=51). Main Outcome Measure: Catheters were removed when no longer needed or suspected as a cause of infection. The tip and a 5-cm segment of the intradermal portion of the catheter were cultured semiquantitatively. Blood cultures were obtained when clinically indicated. The remaining segment of catheters coated with CSS were cut and incubated on an agar plate with strains of Staphylococcus aureus and Enterococcus. Zone of inhibition was determined 24 hours later. Data were analyzed by survival and logistic multivariate regression methods. Results: Catheters coated with CSS were effective in reducing the rate of significant bacterial growth on either the tip or intradermal segment (40%) compared with control catheters (52%; P=.04). However, there was no difference in the incidence of catheter-related bacteremia (3.8% (uncoated) vs 3.3% (coated); P=.81). In vitro activity of catheters with CSS against S aureus was evident up to 25 days but activity against Enterococcus dissipated more quickly over time and was absent by day 4. The most common colonizing organisms were coagulase-negative staphylococcus and enterococcus. Variables that were associated with a significant amount of growth on the tip or intradermal segment were a duration of catheterization of longer than 7 days, jugular insertion site, and the absence of a CSS coating. The use of a guidewire when the catheter was removed was associated with a lower risk of significant bacterial growth. Conclusions: The use of CSS reduces the incidence of significant bacterial growth on either the tip or intradermal segments of coated triple-lumen catheters but has no effect on the incidence of catheter-related bacteremia. In this patient population, catheters coated with CSS provide no additional benefit over uncoated catheters.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 008872112

Download citation: RISBibTeXText

PMID: 9437382

DOI: 10.1001/archinte.158.1.81


Related references

Evaluation of a triple-lumen central venous heparin-coated catheter versus a catheter coated with chlorhexidine and silver sulfadiazine in critically ill patients. Intensive Care Medicine 30(4): 633-638, 2004

Evaluation of a triple-lumen central venous catheter heparin-bonded versus a catheter coated with chlorhexidine and silver sulfadiazine in critically ill patients A randomized, clinical trial. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 426, 2001

A Comparison Of The Time To Catheter Colonization (Cc) And Catheter Related Bloodstream Infection (Crbsi) Between Central Venous Catheters (Cvc) Coated With Either 5-Fluorouracil (5-Fu) Or Chlorhexidine/Silver Sulfadiazine (Ch-Ss). Chest 134(4): s3002-a-s3002-b, 2008

Double-lumen central venous catheters impregnated with chlorhexidine and silver sulfadiazine to prevent catheter colonisation in the intensive care unit setting: a prospective randomised study. Journal of Hospital Infection 72(3): 227-233, 2009

Chlorhexidine and silver sulfadiazine coating on central venous catheters is not sufficient for protection against catheter-related infection: Simulation-based laboratory research with clinical validation. Journal of International Medical Research 45(3): 1042-1053, 2017

Central venous catheters coated with chlorhexidine and silver sulfadiazine: our experience on a cardio-surgical population. European Journal of Anaesthesiology 23(Suppl. 38): 31-32, 2006

Impact of chlorhexidine-silver sulfadiazine-impregnated central venous catheters on in vitro quantitation of catheter-associated bacteria. Journal of Clinical Microbiology 34(10): 2640-2641, 1996

Prevention of intravascular catheter-related infection with newer chlorhexidine-silver sulfadiazine-coated catheters: a randomized controlled trial. Intensive Care Medicine 30(5): 837-843, 2004

Chlorhexidine and silver-sulfadiazine coated central venous catheters in haematological patients--a double-blind, randomised, prospective, controlled trial. Supportive Care in Cancer 13(12): 993, 2005

Antimicrobial chlorhexidine/silver sulfadiazine-coated central venous catheters versus those uncoated in patients undergoing allogeneic stem cell transplantation. Supportive Care in Cancer 17(2): 145-151, 2009

Chlorhexidine-silver sulfadiazine- or rifampicin-miconazole-impregnated venous catheters decrease the risk of catheter-related bloodstream infection similarly. American Journal of Infection Control 44(1): 50-53, 2016

Effect of a second-generation venous catheter impregnated with chlorhexidine and silver sulfadiazine on central catheter-related infections: a randomized, controlled trial. Annals of Internal Medicine 143(8): 570-580, 2005

Reduction of catheter-related infections in neutropenic patients: a prospective controlled randomized trial using a chlorhexidine and silver sulfadiazine-impregnated central venous catheter. Annals of Hematology 84(4): 258-262, 2005

Anti-infective external coating of central venous catheters: a randomized, noninferiority trial comparing 5-fluorouracil with chlorhexidine/silver sulfadiazine in preventing catheter colonization. Critical Care Medicine 38(11): 2095-2102, 2010

Reduction of central venous catheter-related infection in cancer patients with severe neutropenia A prospective controlled randomized trial using a chlorhexidine and silver-sulfadiazine impregnated central venous line. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 447, 2001