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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

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 and Chemotherapy 41: 447

Background: Central venous catheters (CVCs) impregnated with CH-SS have recently been introduced for the prevention of CRI. The purpose of this study was to assess the efficacy of CH-SS impregnated CVCs (ARROWg+ard Blue PlusTM) to prevent CRI in cancer pts with hematological malignancies undergoing chemotherapy followed by severe neutropenia (<100/mul). Proven CVC-related blood stream infection (BSI) was defined as the isolation of the same species from peripheral blood culture and CVC-tip (>15 CFU Maki technique). Methods: A randomized, prospective clinical trial was carried out in consecutive cancer pts to compare CRI using an CH-SS impregnated CVC (n=51) with that using a standard uncoated triple-lumen CVC (n=55) between March and October 2000. Patients were treated for leukemia (n=92), lymphoma (n=10), myeloma (n=3), and myelodysplastic syndrome (n=1). Results: Study groups were balanced regarding to sex, age, underlying disease, insertion site, and duration of severe neutropenia. The CVCs were in-situ a mean of 14,3 (SD 8,2) d in the study group vs 16,6 (SD 9,7) d in the control arm. CVC tip colonization was observed less frequent in the study group (7 pts vs 17 pts; p=0.035). CVC-related BSI were significantly less frequent in the study group (1 vs 8 pts; p=0.02). All CVC-related BSI infections were related to Staphylococcus ssp. Conclusion: In pts with severe neutropenia, CH-SS impregnated CVC yield a significant antibacterial effect against Staphylococcus ssp resulting in a significantly lower rate of CVC tip colonization as well as CVC-related BSI.

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