Central venous catheters revisited--infection rates and an assessment of the new Fibrin Analysing System brush.

Abstract

Sixty-one consecutive patients in the Intensive Care Unit requiring central venous lines (CVC) for five or more days were randomized to receive either a standard triple lumen CVC (STD/CVC) or a silver sulphadiazine and chlorhexidine impregnated CVC (SSD/CVC). Data from the 54 patients who completed the trial show a reduced infection rate (positive tip culture) in the SSD/CVC group (4 out of 28) compared to the STD/CVC group (10 out of 26) (P < 0.05). In addition, the new Fibrin Analysing System (FAS) brush was evaluated and used to determine the presence of infection in all the CVCs (STD/CVC and SSD/CVC combined, n = 54) at day 3 (i.e. early warning of CVC colonization/infection) and at the time of removal of the CVC. The FAS brush was able to detect an infected CVC on only one occasion on day 3 out of the 14 CVC tips which were later found to be colonized/infected at the time of removal. The sensitivity of the FAS brush in detecting colonized/infected CVCs at the time of CVC removal compared with CVC tip culture was 21% with a specificity of 100%. These findings would currently not support the routine use of the FAS brush in determining CVC infection/colonization.

• Authors: P V van Heerden, S A Webb, S Fong, C L Golledge, B L Roberts, W R Thompson
• Journal: Anaesthesia and intensive care (Anaesth Intensive Care) Vol. 24 Issue 3 Pg. 330-3 (Jun 1996) ISSN: 0310-057X [Print] United States
• PMID: 8805887 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Infective Agents, Local
• Chlorhexidine
• Silver Sulfadiazine

Topics

• Acinetobacter (isolation & purification)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Infective Agents, Local (therapeutic use)
• Bacterial Infections (etiology, prevention & control)
• Catheterization, Central Venous (adverse effects, instrumentation)
• Chlorhexidine (therapeutic use)
• Equipment Design
• Female
• Humans
• Intensive Care Units
• Male
• Middle Aged
• Silver Sulfadiazine (therapeutic use)
• Staphylococcus epidermidis (isolation & purification)