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Supportive Care in Cancer
Published in: Supportive Care in Cancer 12/2005

01-12-2005 | Original Article

Chlorhexidine and silver-sulfadiazine coated central venous catheters in haematological patients—a double-blind, randomised, prospective, controlled trial

Authors: Torben Ostendorf, Andrea Meinhold, Christoph Harter, Hans Salwender, Gerlinde Egerer, Heinrich K. Geiss, Antony D. Ho, Hartmut Goldschmidt

Published in: Supportive Care in Cancer | Issue 12/2005

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Abstract

Background

Central venous catheters (CVCs) are essential for the intensive care of patients with haematological illness. Catheter-related infections (CRI) are an important problem in modern medicine, which may lead to life-threatening situations, to prolonged hospitalisation and increased cost. In immunocompromised patients suffering from haemato-oncological diseases, CRI is a significant factor for adverse outcome. Several clinical studies have shown that CVCs coated with antiseptics such as chlorhexidine and silver-sulfadiazine (CHSS) reduce the risk of catheter-related bacteraemia. Most studies, however, were performed on intensive care patients not suffering from chemotherapy-induced immunosuppression.

Patients and methods

A prospective double-blind, randomised, controlled trial was performed to investigate the effectiveness of CHSS-coated catheters in haemato-oncological patients. A total number of 184 catheters (median duration of placement, 11 days) were inserted into 184 patients (male 115, female 69), of which 90 were antiseptically coated. After removal, all catheters were investigated for bacterial growth.

Main results

Catheters coated with CHSS were effective in reducing the rate of significant bacterial growth on either the tip or subcutaneous segment (26%) compared to control catheters (49%). The incidence of catheter colonisation was also significantly reduced (12% coated vs 33% uncoated). Data obtained show a significant reduction of catheter colonisation in CHSS catheters. There was no significant difference in the incidence of catheter-related bacteraemia (3% coated vs 7% uncoated). However, due to the overall low rate of CRI, we could not observe a significant reduction in the incidence of catheter-related bacteraemia.

Conclusion

Our data show that the use of CHSS catheters in patients with haematological malignancy reduces the overall risk of catheter colonisation and CRI, although the incidence of catheter-related bacteremia was similar in both groups.
Literature
1.
Anderson AJ, Krasnow SH, Boyer MW et al (1989) Thrombosis: the major Hickman catheter complication in patients with solid tumor. Chest 95:71–75
2.
Bach A (1995) A definition of catheter-related infection. Zentralbl Bakteriol 283:140–144
3.
Bach A, Bohrer H, Böttiger BW, Motsch J, Martin E (1994) Reduction of bacterial colonization of triple lumen catheters with antiseptic bonding in septic patients. Anesthesiology 81:261–263
4.
Bach A, Borneff M (1996) Infektionen durch intravasale Katheter. Anaesthesist 45:1111–1126
5.
Bach A, Schmidt H, Böttiger B (1996) Retention of antibacterial activity and bacterial colonization of antiseptic-bonded central venous catheters. J Anti-microb Chemother 37:315–322
6.
Bern MM, Lokich JJ, Wallach SR et al (1990) Very low dosis of warfarin can prevent thrombosis in central venous catheters. Ann Intern Med 112:423–428
7.
Centers for Disease Control Working Group (1981) Guidelines for prevention of intravenous therapy-related infections. Infect Control 3:62–79
8.
Ciresi DL, Albrecht RM, Volkers PA, Scholten DJ (1996) Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. Am Surg 62:641–646
9.
Cleri DJ, Corrado ML, Seligman SJ (1980) Quantitative culture of intravenous catheter and other intravascular inserts. J Infect Dis 141:781–788
10.
DeCicco M, Chiaradia V, Veronesi A et al (1989) Source and route of microbial colonisation of parenteral nutrition catheters. Lancet 1989:1266–1269
11.
Ellis ME, Rhydderch D, Zwaan F, Guy ML, Baillie F (1996) High incidence of line-related infection and mechanical failure of an antiseptic impregnated central venous catheter in highly immunocompromised patients. Scand J Infect 28:91–93
12.
Flowers R, Schwenzer KJ, Kopel RF, Fish MJ, Tucker SI, Farr BM (1989) Efficacy of an attachable subcutaneous cuff for the prevention of intravascular catheter-related infection. A randomized controlled trial. JAMA 261:878–883
13.
George SJ, Vuddamalay P, Boscoe MJ (1997) Antiseptic-impregnated central venous catheters reduce the incidence of bacterial colonization and associated infection in immunocompromised transplant patients. Eur J Anaesthesiol 14:428–431
14.
Goldmann DA, Pier GB (1993) Pathogenesis of infections related to intravascular catheterization. Clin Microbiol Rev 6:176–192
15.
Goldschmidt H, Salwender H, Hegenbart U et al (1998) Increased risk of catheter colonization and catheter-related infections in severe immunocompromized patients with multiple myeloma undergoing high-dose glucocorticoid treatment. Zentralbl Bakteriol 287:125–135
16.
Greene FL, Moore W, Strickland G, McFarland J (1988) Comparison of a totally implantable access device for chemotherapy (Port-A-Cath) and long-term percutaneous catheterization (Broviac). South Med J 81:580–603
17.
Guggenbichler JP, Berchtold D, Allerberger F et al (1992) In vitro an in vivo effect of antibiotics on catheters colonized by staphylococci. Eur J Clin Microbiol Infect Dis 11:408–415
18.
Haley RP, Schaberg DR, Crossley KB, Allmen von SD, McGowan JE (1981) Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med 70:51–58
19.
Hannan M, Juste R, Shankar U, Nightingale C, Azadian B, Soni N (1996) Colonization of triple lumen catheters a study on antiseptic bonded and standard catheters. Clin Intensive Care 7:56–57
20.
Harter C, Salwender H, Bach A, Egerer G, Goldschmidt H, Ho AD (2002) Catheter-related infection and thrombosis of the internal jugular vein in haematologic–oncologic patients undergoing chemotherapy. Cancer 94:245–251
21.
Hartmann GE, Shochat SJ (1987) Management of septic complications associated with Silastic catheters in childhood malignancy. Pediatr Infect Dis J 6:1042–1047
22.
Heard SO, Wagle M, Vijayakumar E (1998) Influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia. Arch Intern Med 158:81–87
23.
Heerden van PV, Webb SAR, Fong S, Golledge CL, Roberts BL (1996) Central venous catheters revisited: infection rates and an assessment of the new fibrin analysing system brush. Anaesth Intensive Care 24:330–333
24.
Hiemenz J, Skelton J, Pizza PA (1986) Perspective on the management of catheter-related infections in cancer patients. Pediatr Infect Dis J 5:6–11
25.
Howell PB, Walters P, Donowitz GR, Farr BM (1995) Risk factors for infection of adult patients with cancer who have tunnelled central venous catheters. Cancer 75:1367–1375
26.
Keohane PP, Jones BJ, Attrill H et al (1983) Effect of catheter tunnelling and a nutrition nurse on catheter sepsis during parenteral nutrition. A controlled trial. Lancet 17:1388–1390
27.
Logghe C, Ossel van CH, D’Hoore W, Ezzedine H, Wauters G, Haxhe JJ (1997) Evaluation of chlorhexidine and silver-sulfadiazine impregnated central venous catheters for the prevention of bloodstream infection in leukaemic patients: a randomized controlled trial. J Hosp Infect 37:145–156
28.
Lokich JJ, Becker B (1983) Subclavian vein thrombosis in patients treated with infusion chemotherapy for advanced malignancy. Cancer 52:1586–1589
29.
Maki DG, Botticelli JT, LeRoy ML, Thielke TS (1987) Prospective study of replacing administration sets for intravenous therapy at 48- vs 72-hour intervals. J Am Med Assoc 258:1777–1781
30.
Maki DG, Stolz SM, Wheeler S, Mermel LA (1997) Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med 127:257–266
31.
Maki DG, Weise CE, Sarafin HW (1977) A semi quantitative culture method for identifying intravenous catheter-related infection. N Engl J Med 296:1305–1309
32.
Mermel LA (2000) Prevention of intravascular catheter-related infections. Ann Intern Med 132:391–402
33.
Meunier F, Vam der Auwera P, Auoun M, Bron D (1990) Ceftazidime plus teicoplanin versus ceftazidime plus amikacin as empiric therapy for fever in cancer patients with granulocytopenia. Br J Haematol 76(Suppl. 2):49–53
34.
Pemberton LB, Ross V, Cuddy P, Kremer H, Fresier T, McGurk E (1996) No difference in catheter sepsis between standard and antiseptic central venous catheters. Arch Surg 131:986–989
35.
Ramsay J, Nolte F, Schwarzmann S (1994) Incidence of catheter colonization and catheter related infection with an antiseptic impregnated triple lumen catheter. Crit Care Med 22:A115
36.
Shaw JHF, Douglas R, Wilson T (1988) Clinical performance of Hickman and Port-A-Cath artrial catheters. Aust N Z J Surg 58:657–659
37.
Sherertz RJ, Raad II, Belani A, Koo LC, Rand KH, Pickett DL, Straub SA, Fauerbach LL (1990) Three-year experience with sonicated vascular catheter cultures in a clinical microbiology laboratory. J Clin Microbiol 28:76–82
38.
Tennenberg S, Lieser M, McCurdy B (1997) A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections. Arch Surg 132:1351–1358
39.
Veenstra DL, Saint S, Saha S, Lumley T, Sullivan SD (1999) Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis. JAMA 281:261–267
40.
Veenstra DL, Saint S, Sullivan SD (1999) Cost-effectiveness of antiseptic-impregnated central venous catheters for the prevention of catheter-related bloodstream infection. JAMA 282:554–560
41.
Weightman NC, Simpson EM, Speller DC, Mott MG (1988) Bacteraemia related to indwelling central venous catheters: prevention, diagnoses and treatment. Eur J Clin Microbiol Infect Dis 7:125–129
Metadata
Title
Chlorhexidine and silver-sulfadiazine coated central venous catheters in haematological patients—a double-blind, randomised, prospective, controlled trial
Authors
Torben Ostendorf
Andrea Meinhold
Christoph Harter
Hans Salwender
Gerlinde Egerer
Heinrich K. Geiss
Antony D. Ho
Hartmut Goldschmidt
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 12/2005
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-005-0812-9

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