Abstract | BACKGROUND: OBJECTIVE: To ascertain 1) effectiveness of a second-generation antiseptic-coated catheter in the prevention of microbial colonization and infection; 2) safety and tolerability of this device; 3) microbiology of infected catheters; and 4) propensity for the development of antiseptic resistance. DESIGN: Multicenter, randomized, double-blind, controlled trial. SETTING: 9 university-affiliated medical centers. PATIENTS: 780 patients in intensive care units who required central venous catheterization. INTERVENTION: MEASUREMENTS: RESULTS: Patients with the 2 types of catheters had similar demographic features, clinical interventions, laboratory values, and risk factors for infection. Antiseptic catheters were less likely to be colonized at the time of removal compared with control catheters (13.3 vs. 24.1 colonized catheters per 1000 catheter-days; P < 0.01). The center-stratified Cox regression hazard ratio for colonization controlling for sampling design and potentially confounding variables was 0.45 (95% CI, 0.25 to 0.78). The rate of definitive catheter-related bloodstream infection was 1.24 per 1000 catheter-days (CI, 0.26 to 3.62 per 1000 catheter-days) for the control group versus 0.42 per 1000 catheter-days (CI, 0.01 to 2.34 per 1000 catheter-days) for the antiseptic catheter group (P = 0.6). Coagulase-negative staphylococci and other gram-positive organisms were the most frequent microbes to colonize catheters. Noninfectious adverse events were similar in both groups. Antiseptic susceptibility was similar for microbes recovered from either group. LIMITATIONS: CONCLUSIONS:
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Authors | Mark E Rupp, Steven J Lisco, Pamela A Lipsett, Trish M Perl, Kevin Keating, Joseph M Civetta, Leonard A Mermel, David Lee, E Patchen Dellinger, Michael Donahoe, David Giles, Michael A Pfaller, Dennis G Maki, Robert Sherertz |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 143
Issue 8
Pg. 570-80
(Oct 18 2005)
ISSN: 1539-3704 [Electronic] United States |
PMID | 16230723
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Infective Agents, Local
- Chlorhexidine
- Silver Sulfadiazine
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Topics |
- Aged
- Anti-Infective Agents, Local
(administration & dosage)
- Bacteremia
(prevention & control)
- Catheterization, Central Venous
(instrumentation)
- Catheters, Indwelling
- Chlorhexidine
(administration & dosage)
- Double-Blind Method
- Equipment Contamination
- Female
- Humans
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Silver Sulfadiazine
(administration & dosage)
- Skin
(microbiology)
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