Titre du document / Document title

Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. Discussion

Auteur(s) / Author(s)

CIRESI D. L. ⁽¹⁾ ; ALBRECHT R. M. ⁽¹⁾ ; VOLKERS P. A. ⁽¹⁾ ; SCHOLTEN D. J. ⁽¹⁾ ; SENAGORE A. (Commentateur) ; BODZIN J. H. (Commentateur) ; DEZIEL D. (Commentateur) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Departments of Surgery, Butterworth Hospital and Michigan State University, Grand Rapids, Michigan, ETATS-UNIS

Résumé / Abstract

Infection associated with the use of triple lumen catheters in hospitals is a frequent and serious complication. The prevailing hypothesis for the origin of catheter-related infection (CRI) is bacterial colonization and subsequent infection of the skin insertion site and catheter interface. The recently released ARROWgard catheter contains a bonded synergistic combination of silver sulfadiazine and chlorhexidine, which is thought to render the catheter resistant to bacterial colonization and subsequent sepsis. The purpose of this study is to compare the incidence of CRI and catheter-related sepsis (CRS) between a standard triple lumen catheter and ARROWgard antiseptic coated catheter in patients receiving total parenteral nutrition (TPN). A randomized, prospective clinical trial was conducted at a community referral center from January 1993 through April 1994. One-hundred-ninety-one patients with need for TPN were randomized to receive either the ARROWgard or a standard triple lumen catheter placed under a strict sterile protocol. CRI was defined as ≥15 colony forming units by semiquantitative culture technique of the catheter tip or intracutaneous segment. CRS was defined as growth of the same organism on the catheter and at least one peripheral blood culture. All catheters were cultured. Ninety-two patients received the ARROWgard catheter, and 99 patients received the standard catheter. There were no differences between the average age, sex, length of hospital stay, days on TPN, number of catheters/patient, indications for TPN, primary diagnoses, or duration of the central line between the two group. The overall rate of CRI was 11.5 per cent, and CRS was 8.4 per cent in this study. The rate of CRI for the ARROWgard was 10.9 per cent, compared with 12.9 per cent for the standard catheter (P = NS The rate of CRS for the ARROWgard was 8.7 per cent, compared with 8.1 per cent for the standard catheter (P = NS The coating of central venous catheters with silver sulfadiazine and chlorhexidine does not reduce the rate CRI or CRS when compared with standard central venous catheters in patients receiving TPN.

Revue / Journal Title

The American surgeon   ISSN 0003-1348   CODEN AMSUAW 

Source / Source

Congrès
Midwest Surgical Association Meeting, Grand Traverse, Michigan , ETATS-UNIS (13/08/1995)
1996, vol. 62, n^o 8, pp. 619-657 (27 ref.), pp. 641-646

Langue / Language

Anglais

Editeur / Publisher

Southeastern Surgical Congress, Atlanta, GA, ETATS-UNIS  (1951) (Revue)

Mots-clés anglais / English Keywords

Catheter ; Central vein ; Nutrition ; Parenteral administration ; Coating ; Antiinfectious ; Sulfanilamide derivatives ; Antiseptic ; Chemotherapy ; Bacteriosis ; Treatment ; Prevention ; Comparative study ; Human ; Infection ;

Mots-clés français / French Keywords

Cathéter ; Veine centrale ; Nutrition ; Voie parentérale ; Enrobage ; Sulfadiazine ; Chlorhexidine ; Antiinfectieux ; Sulfamides ; Antiseptique ; Chimiothérapie ; Bactériose ; Traitement ; Prévention ; Etude comparative ; Homme ; Infection ;

Mots-clés espagnols / Spanish Keywords

Catéter ; Vena central ; Nutrición ; Vía parenteral ; Envoltura ; Antiinfeccioso ; Sulfamidas ; Antiséptico ; Quimioterapia ; Bacteriosis ; Tratamiento ; Prevención ; Estudio comparativo ; Hombre ; Infección ;

Localisation / Location

INIST-CNRS, Cote INIST : 8324, 35400006369798.0060