Antiseptic coating of intravascular
catheters may be an effective means of decreasing
catheter-related colonization and subsequent
infection. The purpose of this study was to assess the efficacy of
chlorhexidine and
silver sulfadiazine (CH-SS)-impregnated
central venous catheters (CVCs) to prevent
catheter-related colonization and
infection in patients with
hematological malignancies who were subjected to intensive
chemotherapy and suffered from severe and sustained
neutropenia. Proven CVC-related
bloodstream infection (BSI) was defined as the isolation of the same species from peripheral blood culture and CVC tip (Maki technique). This randomized, prospective clinical trial was carried out in 106 patients and compared
catheter-related colonization and BSI using a CH-SS-impregnated CVC (n=51) to a control arm using a standard uncoated triple-lumen CVC (n=55). Patients were treated for acute
leukemia (n=89),
non-Hodgkin's lymphoma (n=10), and
multiple myeloma (n=7). Study groups were balanced regarding to age, sex, underlying diseases, insertion site, and duration of
neutropenia. The CVCs were in situ a mean of 14.3+/-8.2 days (mean+/-SD) in the study group versus 16.6+/-9.7 days in the control arm.
Catheter-related colonization was observed less frequently in the study group (five vs nine patients; p=0.035). CVC-related BSI were significantly less frequent in the study group (one vs eight patients; p=0.02). In summary, in patients with severe
neutropenia, CH-SS-impregnated CVCs yield a significant antibacterial effect resulting in a significantly lower rate of
catheter-related colonization as well as CVC-related BSI.