Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(2):154-160 | DOI: 10.5507/bp.2019.022
The efficacy of a non-leaching antibacterial central venous catheter - a prospective, randomized, double-blind study
- a Department of Pain Treatment, Department of Paediatric Anaesthesiology and Resuscitation, University Hospital Brno and Department of Paediatric Anaesthesiology and Resuscitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- b Department of Anesthesiology and Critical Care, University Hospital Kralovske Vinohrady, Prague, and Department of Anaesthesiology and Resuscitation, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
- c Department of Surgery, University Hospital Brno, Brno, Czech Republic
- d Department of Anesthesiology and Critical Care, University Hospital Kralovske Vinohrady, Prague, Czech Republic
- e Department of Clinical Microbiology, University Hospital Brno, Brno and Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- f Dr. Roschke GMBH, Cologne, Germany
- g Depatment of Anaesthesiology and Resuscitation, University Hospital Ostrava and Department of Intensive Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
Background: Antimicrobial coatings of central venous catheters (CVC) have the potential to reduce the risk of infectious complications. The aim of this study was to examine the efficacy of a catheter with a non-leaching antimicrobial coating against catheter colonization and bloodstream infections (BSI).
Methods: The study was conducted in two centers using a prospective, randomized, double-blind and controlled design (680 intensive care patients; a protective CVC (Certofix® protect) or a standard CVC (Certofix®). Primary objectives were the rates of catheter colonization and BSI in the two groups. Other baseline demographics, APACHE II score, insertion site, location of CVC placement (ICU or theatre), indwelling time and length of ICU stay were comparable for both groups.
Results: While the rate of catheter colonization between the coated and uncoated CVC (17.4% vs. 18.7%, P=0.7477) and the rate of microbiologically confirmed catheter associated infections were similar (1.4% vs. 1.9%, P=0.7521), the coated CVC showed a significantly lower incidence of BSI (2.0% vs. 6.5%, P=0.0081) and a significantly lower mean incidence of BSI per 1000 catheter days (3.2 vs. 8.3, P=0.0356).
Conclusion: The non-leaching antibacterial coating of the protective catheter was effective in reducing the incidence of BSI but not the rate of catheter colonization. However, the incidence of BSI is a better surrogate marker for the risk of developing clinical signs of infection suggesting that use of the non-leaching protective catheter is effective in this regard. Trial number: ClinicalTrials.gov (ID: NCT00555282), https://clinicaltrials.gov/show/NCT00555282
Keywords: antimicrobial, CVC, non-leaching, catheter-related bloodstream infections
Received: February 7, 2019; Revised: May 15, 2019; Accepted: May 15, 2019; Prepublished online: May 28, 2019; Published: June 18, 2020 Show citation
ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
References
- Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006;81:1159-71.
Go to original source...
Go to PubMed...
- Teichgräber UK, Gebauer B, Benter T, Wagner J. Long-term central venous lines and their complications. Rofo 2004;176: 944-52.
Go to original source...
Go to PubMed...
- Simon A, Ammann RA, Bode U, Fleischhack G, Wenchel HM, Schwamborn D, Gravou C, Schlegel PG, Rutkowski S, Dannenberg C, Körholz D, Laws HJ, Kramer MH. Healthcare-associated infections in pediatric patients: results of a prospective study from university hospitals in Germany and Switzerland. BMC Infectious Diseases 2008;8:70.
Go to original source...
Go to PubMed...
- Frasca D, Dahyot-Fizelier C, Mimoz O. Prevention of central venous catheter-related infection in the intensive care unit. Critical Care 2010;14:212.
Go to original source...
Go to PubMed...
- Byrnes MC, Coopersmith CM. Prevention of catheter-related bloodstream infection. Curr Opin Crit Care 2007;13:411-5.
Go to original source...
Go to PubMed...
- Tan CC, Zanariah Y, Med M, Lim KI, Balan S. Central venous catheter-related bloodstream infections: incidence and an analysis of risk factors. Med J Malaysia 2007;62:370-4.
Go to PubMed...
- Yousif A, Jamal MA, Raad I. Biofilm-based central line-associated bloodstream infections. Adv Exp Med Biol. 2015;830:157-79.
Go to original source...
Go to PubMed...
- Elliot P. Prevention of intravascular catheter-related infections. In: Hamilton H, Bodenham AR, editors. Central venous catheters. Chichester: Wiley-Blackwell; 2009. p. 210-2.
Go to original source...
- Gilbert RE, Harden M. Effectiveness of impregnated central venous catheters for catheter related bloodstream infection: a systematic review. Curr Opin Infect Dis 2008;21:235-45.
Go to original source...
Go to PubMed...
- Wang H, Huang T, Jing J, Jin J, Wang P, Yang M, Cui W, Zheng Y, Shen H. Effectiveness of different central venous catheters for catheter-related infections: a network meta-analysis. J Hosp Infect 2010;76:1-11.
Go to original source...
Go to PubMed...
- Ramritu P, Halton K, Collignon P, Cook D, Fraenkel D, Battistutta D, Whitby M, Graves N. A systematic review comparing the relative effectiveness of antimicrobial-coated catheters in intensive care units. Am J Infect Control 2008;36:104-17.
Go to original source...
Go to PubMed...
- Wang H, Tong H, Liu H, Wang Y, Wang R, Gao H, Yu P, Lv Y, Chen S, Wang G, Liu M, Li Y, Yu K, Wang C. Effectiveness of antimicrobial-coated central venous catheters for preventing catheter-related blood-stream infections with the implementation of bundles: a systematic review and network meta-analysis. Ann Intensive Care. 2018;8(1):71.
Go to original source...
Go to PubMed...
- Hockenhull JC, Dwan K, Boland A, Smith G, Bagust A, Dündar Y, Gamble C, McLeod C, Walley T, Dickson R. The clinical effectiveness and cost-effectiveness of central venous catheters treated with anti-infective agents in preventing bloodstream infections: a systematic review and economic evaluation. Health Technology Assessment 2008;12:1-154.
Go to original source...
Go to PubMed...
- Chong HY, Lai NM, Apisarnthanarak A, Chaiyakunapruk N. Comparative Efficacy of Antimicrobial Central Venous Catheters in Reducing Catheter-Related Bloodstream Infections in Adults: Abridged Cochrane Systematic Review and Network Meta-Analysis. 2017;64(suppl_2):131-40.
Go to original source...
Go to PubMed...
- Richards GA, Brink AJ, McIntosh R, Steel HC, Cockeran R. Investigation of biofilm formation on a charged intravenous catheter relative to that on a similar but uncharged catheter. Med Devices (Auckl) 2014;7:219-24.
Go to original source...
Go to PubMed...
- Bauer P, Köhne K. Evaluation of Experiments with Adaptive Interim Analysis: Biometrics 1994;50(4):1029-41.
Go to original source...
Go to PubMed...
- Gowardman JR, Robertson IK, Parkes S, Rickard CM. Influence of insertion site on central venous catheter colonization and bloodstream infection rates. Intensive Care Med 2008;34:1038-45.
Go to original source...
Go to PubMed...
- Nagashima G, Kikuchi T, Tsuyuzaki H, Kawano R, Tanaka H, Nemoto H, Taguchi K, Ugajin K. To reduce catheter-related bloodstream infections: is the subclavian route better than the jugular route for central venous catheterization? J Infect Chemother 2006;12:363-5.
Go to original source...
Go to PubMed...
- van der Kooi TII, Wille JC, van Benthem BHB. Catheter application, insertion vein and length of ICU stay prior to insertion affect the risk of catheter-related bloodstream infection. J Hosp Infect 2012;80:238-44.
Go to original source...
Go to PubMed...
- Camargo LF, Marra AR, Büchele GL, Sogayar AM, Cal RG, de Sousa JM, Silva E, Knobel E, Edmond MB. 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. J Hosp Infect 2009;72:227-33.
Go to original source...
Go to PubMed...
- Kalfon P, de Vaumas C, Samba D, Boulet E, Lefrant JY, Eyraud D, Lherm T, Santoli F, Naija W, Riou B. Comparison of silver-impregnated with standard multi-lumen central venous catheters in critically ill patients. Crit Care Med 2007;35:1032-9.
Go to original source...
Go to PubMed...
- Darouiche RO, Berger DH, Khardori N, Robertson CS, Wall MJ Jr, Metzler MH, Shah S, Mansouri MD, Cerra-Stewart C, Versalovic J, Reardon MJ, Raad II. Comparison of antimicrobial impregnation with tunneling of long-term central venous catheters: a randomized controlled trial. Ann Surg 2005;242:193-200.
Go to original source...
Go to PubMed...
- O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee (HICPAC) (2011). Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93.
Go to original source...
Go to PubMed...
- Charalambous CC, Swobody SM, Dick J, Perl T, Lispett PA. Risk factors and clinical impact of central line infections in the surgical intensive care unit. Arch Surg 1998;133(11):1241-6.
Go to original source...
Go to PubMed...
- Lorente L. Antimicrobial-impregnated catheters for the prevention of catheter-related bloodstream infections. World J Crit Care Med 2016;5(2):137-42.
Go to original source...
Go to PubMed...
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.