TY - JOUR
T1 - Effect of chlorhexidine/silver sulfadiazine-impregnated central venous catheters in an intensive care unit with a low blood stream infection rate after implementation of an educational program
T2 - A before-after trial
AU - Schuerer, Douglas J.E.
AU - Zack, Jeanne E.
AU - Thomas, James
AU - Borecki, Ingrid B.
AU - Sona, Carrie S.
AU - Schallom, Marilyn E.
AU - Venker, Melissa
AU - Nemeth, Jennifer L.
AU - Ward, Myrna R.
AU - Verjan, Linda
AU - Warren, David K.
AU - Fraser, Victoria J.
AU - Mazuski, John E.
AU - Boyle, Walter A.
AU - Buchman, Timothy G.
AU - Coopersmith, Craig M.
PY - 2007/8
Y1 - 2007/8
N2 - Background: Current guidelines recommend using antiseptic- or antibiotic-impregnated central venous catheters (CVCs) if, following a comprehensive strategy to prevent catheter-related blood stream infection (CR-BSI), infection rates remain above institutional goals based on benchmark values. The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate. Methods: Pre-intervention and post-intervention observational study in a 24-bed surgical/trauma/burn ICU from October, 2002 to August, 2005. All patients requiring CVC placement after March, 2004 had a chlorhexidine/silver sulfadiazine-impregnated catheter inserted (post-intervention period). Results: Twenty-three CR-BSIs occurred in 6,960 catheter days (3.3 per 1,000 catheter days) during the 17-month control period. After introduction of chlorhexidine/silver sulfadiazine-impregnated catheters, 16 CR-BSIs occurred in 7,732 catheter days (2.1 per 1,000 catheter days; p = 0.16). The average length of time required for an infection to become established after catheterization was similar in the two groups (8.4 vs. 8.6 days; p = 0.85). Chlorhexidine/silver sulfadiazine-impregnated catheters did not result in a statistically significant change in the microbiological profile of CR-BSIs, nor did they increase the incidence of resistant organisms. Conclusions: Although chlorhexidine/silver sulfadiazine-impregnated catheters are useful in specific patient populations, they did not result in a statistically significant decrease in the CR-BSI rate in this study, beyond what was achieved with education alone.
AB - Background: Current guidelines recommend using antiseptic- or antibiotic-impregnated central venous catheters (CVCs) if, following a comprehensive strategy to prevent catheter-related blood stream infection (CR-BSI), infection rates remain above institutional goals based on benchmark values. The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate. Methods: Pre-intervention and post-intervention observational study in a 24-bed surgical/trauma/burn ICU from October, 2002 to August, 2005. All patients requiring CVC placement after March, 2004 had a chlorhexidine/silver sulfadiazine-impregnated catheter inserted (post-intervention period). Results: Twenty-three CR-BSIs occurred in 6,960 catheter days (3.3 per 1,000 catheter days) during the 17-month control period. After introduction of chlorhexidine/silver sulfadiazine-impregnated catheters, 16 CR-BSIs occurred in 7,732 catheter days (2.1 per 1,000 catheter days; p = 0.16). The average length of time required for an infection to become established after catheterization was similar in the two groups (8.4 vs. 8.6 days; p = 0.85). Chlorhexidine/silver sulfadiazine-impregnated catheters did not result in a statistically significant change in the microbiological profile of CR-BSIs, nor did they increase the incidence of resistant organisms. Conclusions: Although chlorhexidine/silver sulfadiazine-impregnated catheters are useful in specific patient populations, they did not result in a statistically significant decrease in the CR-BSI rate in this study, beyond what was achieved with education alone.
UR - http://www.scopus.com/inward/record.url?scp=34848915471&partnerID=8YFLogxK
U2 - 10.1089/sur.2006.073
DO - 10.1089/sur.2006.073
M3 - Article
C2 - 17883361
AN - SCOPUS:34848915471
SN - 1096-2964
VL - 8
SP - 445
EP - 454
JO - Surgical Infections
JF - Surgical Infections
IS - 4
ER -