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含氯己定和磺胺嘧啶银的双腔中心静脉导管预防重症监护病房环境中导管定植的前瞻性随机研究。

Double-lumen central venous catheters impregnated with chlorhexidine and silver sulfadiazine to prevent catheter colonisation in the intensive care unit setting: a prospective randomised study.

作者信息

Camargo L F A, Marra A R, Büchele G L, Sogayar A M C, Cal R G R, de Sousa J M A, Silva E, Knobel E, Edmond M B

机构信息

Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.

出版信息

J Hosp Infect. 2009 Jul;72(3):227-33. doi: 10.1016/j.jhin.2009.03.018. Epub 2009 May 13.

Abstract

Antimicrobial- and antiseptic-impregnated catheters are strategies recommended to prevent central venous catheter (CVC) colonisation. Few data regarding chlorhexidine/silver sulfadiazine-impregnated catheters in intensive care unit (ICU) patients have been reported. We performed a prospective, randomised study comparing the colonisation rates of chlorhexidine/silver sulfadiazine-impregnated CVCs (group 1) against standard CVCs (group 2). In order to assess catheter colonisation rates, a 4cm segment from the tips of aseptically removed catheters was cultured by the roll-plate method. In all, 109 patients were enrolled with successful catheter insertion, 51 of them in group 1 and 58 in group 2. There were no statistically significant differences between the two groups with regards to age, Sequential Organ Failure Assessment (SOFA) score, ICU admission diagnosis, infection risk, catheter insertion sites or catheter length of stay. The colonisation rates were 29.4% (15 catheters) for group 1 and 34.5% (20 catheters) for group 2 (P=0.50). Double-lumen CVCs impregnated with chlorhexidine and silver sulfadiazine were not effective in reducing the incidence of catheter colonisation in ICU patients.

摘要

抗菌和含防腐剂的导管是推荐用于预防中心静脉导管(CVC)定植的策略。关于重症监护病房(ICU)患者使用洗必泰/磺胺嘧啶银浸渍导管的数据报道较少。我们进行了一项前瞻性随机研究,比较洗必泰/磺胺嘧啶银浸渍CVC(第1组)与标准CVC(第2组)的定植率。为了评估导管定植率,采用滚平板法对无菌取出的导管尖端4cm段进行培养。总共纳入了109例导管插入成功的患者,其中第1组51例,第2组58例。两组在年龄、序贯器官衰竭评估(SOFA)评分、ICU入院诊断、感染风险、导管插入部位或导管留置时间方面无统计学显著差异。第1组的定植率为29.4%(15根导管),第2组为34.5%(20根导管)(P = 0.50)。含洗必泰和磺胺嘧啶银的双腔CVC在降低ICU患者导管定植发生率方面无效。

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