Lorente Leonardo, Lecuona María, Ramos María José, Jiménez Alejandro, Mora María L, Sierra Antonio
Department of Critical Care, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
Clin Infect Dis. 2008 Nov 1;47(9):1171-5. doi: 10.1086/592253.
The guidelines of the Centers for Disease Control and Prevention do not recommend the use of an antimicrobial- or antiseptic-impregnated catheter for short-term use. In previous studies, we have found a higher incidence of central venous catheter-related bacteremia among patients with femoral and central jugular accesses than among patients with other venous accesses.
The objective of our study was to determine the incidence of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters and standard catheters in patients with femoral and central jugular venous accesses.
This was a cohort study, conducted in the 24-bed polyvalent medical-surgical intensive care unit of a university hospital. We included patients who were admitted to the intensive care unit from 1 June 2006 through 30 September 2007 and who underwent femoral or central jugular venous catheterization.
We inserted 184 femoral (73 rifampicin-miconazole-impregnated catheters and 111 standard catheters) and 241 central jugular venous catheters (114 rifampicin-miconazole-impregnated catheters and 127 standard catheters). We found a lower rate of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters than with standard catheters among patients with femoral access (0 vs. 8.62 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.86; P = .03) and among patients with central internal jugular access (0 vs. 4.93 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.93; P = .04).
Rifampicin-minonazole-impregnated catheters are associated with a statistically significant reduction in the incidence of catheter-related bacteremia in patients with short-term catheter use at the central jugular and femoral sites.
疾病控制与预防中心的指南不推荐短期使用抗菌或含防腐剂的导管。在先前的研究中，我们发现股静脉和颈内静脉置管患者的中心静脉导管相关菌血症发生率高于其他静脉置管患者。
我们研究的目的是确定在股静脉和颈内静脉置管患者中，利福平-咪康唑涂层导管和标准导管相关的中心静脉导管相关菌血症的发生率。
这是一项队列研究，在一家大学医院有24张床位的多科医疗-外科重症监护病房进行。我们纳入了2006年6月1日至2007年9月30日入住重症监护病房且接受股静脉或颈内静脉置管的患者。
我们置入了184根股静脉导管（73根利福平-咪康唑涂层导管和111根标准导管）和241根颈内静脉导管（114根利福平-咪康唑涂层导管和127根标准导管）。我们发现，在股静脉置管患者中，利福平-咪康唑涂层导管相关的中心静脉导管相关菌血症发生率低于标准导管（每1000导管日0例vs. 8.62例；优势比，0.13；95%置信区间，0.00 - 0.86；P = 0.03），在颈内静脉置管患者中也是如此（每1000导管日0例vs. 4.93例；优势比，0.13；95%置信区间，0.00 - 0.93；P = 0.04）。
对于在颈内静脉和股静脉部位短期使用导管的患者，利福平-咪康唑涂层导管与导管相关菌血症发生率的统计学显著降低相关。
