Chlorhexidine-silver sulfadiazine-impregnated venous catheters are efficient even at subclavian sites without tracheostomy

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• 作者：Leonardo Lorente ; MD ; PhD^a ; ^{lorentemartin@msn.com} ; Marí ; a Lecuona ; MD ; PhD^b ; Alejandro Jimé ; nez ; PhD^c ; Judith Cabrera ; MD^a ; Ruth Santacreu ; MD^a ; Lisset Lorenzo ; MD^a ; Lorena Raja ; MD^a ; Marí ; a L. Mora ; MD ; PhD^a
• 关键词：Central venous catheter ; Bacteremia
• 刊名：American Journal of Infection Control
• 出版年：2016
• 出版时间：1 December 2016
• 年：2016
• 卷：44
• 期：12
• 页码：1526-1529
• 全文大小：322 K
• 卷排序：44

文摘

Chlorhexidine-silver sulfadiazine (CHSS)-impregnated catheters have been found to decrease the risk of catheter-related bloodstream infection (CRBSI) and central venous catheter (CVC)-related costs. However, there are no published data about cost-effectiveness of the use of CHSS-impregnated catheters in subclavian venous access without the presence of tracheostomy (thus, with a very low risk of CRBSI). That was the objective of this study.MethodsThis was a retrospective study of patients admitted to a mixed intensive care unit who underwent placement of subclavian venous catheters without the presence of tracheostomy.ResultsPatients with standard catheters (n = 747) showed a higher CRBSI incidence density (0.95 vs 0/1,000 catheter-days; P = .02) and higher CVC-related cost per day ($3.78 ± $7.43 vs $3.31 ± $2.72; P < .001) than patients with a CHSS-impregnated catheter (n = 879). Exact logistic regression analysis showed that catheter duration (P = .02) and the type of catheter used (P = .01) were associated with the risk of CRBSI. Kaplan-Meier method showed that CHSS-impregnated catheters were associated with more prolonged CRBSI-free time than standard catheters (log-rank = 9.76; P = .002). Poisson regression analysis showed that CHSS-impregnated catheters were associated with a lower central venous catheter-related cost per day than standard catheters (odds ratio, 0.87; 95% confidence interval, 0.001-0.903; P < .001).ConclusionsThe use of CHSS-impregnated catheters is an effective and efficient measure for the prevention of CRBSI even at subclavian venous access sites without the presence of tracheostomy.