Antiseptic on catheters lowers infection risk

Researchers report that impregnating catheters with chlorhexidine and silver sulfadiazine significantly reduces the risk of bloodstream infection and bacterial colonization associated with central venous catheters.1

The team assessed the efficacy of central venous catheters impregnated with the antiseptics and reports the procedure reduces the risk of bloodstream infection by approximately 44% and the risk of catheter bacterial colonization by 56%.

In a related study, another group of researchers found that impregnating catheters with minocycline and rifampin prevents even more infections than those impregnated with chlorhexidine and silver sulfadiazine.2 After culturing the tips and subcutaneous segments of 738 catheters — 356 with the minocycline-rifampin mix and 382 with the chlorhexidine-silver sulfadiazine mix — they found that the former were a third as likely to be colonized and one-twelfth as likely to have caused blood infections.

Several methods have been used to prevent catheter-related infections, including aseptic insertion techniques and proper catheter care, but silver-coated catheter cuffs have produced mixed results. Despite these precautions, central venous cathe ters remain a significant source of nosocomial infections. Although antibiotic-coated catheters show clinical promise, the technical requirements for coating the catheter and antibiotic resistance concerns may limit their wide spread use, the researchers said. However, in high-risk patients requiring short-term catheterization, the technique may provide a strategy for decreasing overall incidence and cost of catheter-related infections.

References

1. Veenstra DL, Saint S, Saha S, et al. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection. JAMA 1999; 281: 261-267.

2. Darouiche RO, Raad II, Heard SO, et al. A comparison of two antimicrobial-impregnated central venous catheters. N Engl J Med 1999; 340:1-8.