RESUMEN
BACKGROUND: The objective of this study was to compare the incidence of catheter-related bloodstream infection (CRBSI) with the use of second-generation chlorhexidine-silver sulfadiazine (CHSS)-impregnated catheters, rifampicin-miconazole (RM)-impregnated catheters, and standard catheters. METHODS: Retrospective study of patients admitted to an intensive care unit who received CHSS, RM, or standard catheters in femoral venous access. RESULTS: We diagnosed 18 CRBSIs in 245 patients with standard catheters in 2,061 days, zero CRBSI in 169 patients with CHSS-impregnated catheters in 1,489 days, and zero CRBSI in 227 patients with RM-impregnated catheters in 2,009 days. Patients with standard catheters compared with CHSS- and RM-impregnated catheters showed a higher rate of CRBSI (7.3%, 0%, and 0%, respectively; P < .001) and higher incidence density of CRBSI (8.7, 0, and 0 per 1,000 catheter days, respectively; P < .001). We found in the exact Poisson regression that standard catheters were associated with a higher CRBSI incidence than CHSS-impregnated catheters (P < .001) and RM-impregnated catheters (P < .001), controlling for catheter duration. We found in survival analysis that standard catheters were associated with a lower CRBSI-free time than CHSS-impregnated catheters (P < .001) and RM-impregnated catheters (P < .001). CONCLUSION: We found that CHSS- and RM-impregnated catheters decreased similarly the risk of CRBSI.
Asunto(s)
Antiinfecciosos/administración & dosificación , Bacteriemia/prevención & control , Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/efectos adversos , Catéteres Venosos Centrales/microbiología , Anciano , Cateterismo Venoso Central/métodos , Catéteres Venosos Centrales/efectos adversos , Clorhexidina/administración & dosificación , Femenino , Humanos , Incidencia , Unidades de Cuidados Intensivos , Masculino , Miconazol/administración & dosificación , Persona de Mediana Edad , Estudios Retrospectivos , Rifampin/administración & dosificación , Riesgo , Sulfadiazina de Plata/administración & dosificaciónRESUMEN
Sixty-four patients with chlorhexidine-silver sulfadiazine-impregnated catheters had a lower rate of catheter-related bloodstream infection and lower central venous catheter-related costs per catheter day than 190 patients with a standard catheter.