Institute for Naturopathy, University Hospital of Cologne, Köln, Germany.
Anticancer Res. 2010 Apr;30(4):1353-8.
Antimicrobial central venous catheters are discussed as a device to reduce catheter-related infections. Previously we have reported a study with 223 adult surgical patients randomized to receive either a rifampicin-miconazole-loaded central venous catheter (CVC) (n=118) or a standard CVC (n=105). The antimicrobial CVC was shown to reduce catheter colonization (CC) and catheter-related local infection (CRI) significantly even at long-term catheterization. Here, we present further evaluation of the study focusing on possible benefits for high-risk patients. Subgroup analyses showed a pronounced reduction of CC and CRI in male, overweight and oncology patients. Important covariates were skin colonization for CC and oncological disease for CRI. Odds ratio (OR) for reducing CC was 0.076 (95% CI: 0.016-0.360) and CRI was reduced from 26% to 2.3% (p=0.001) in the cancer subgroup. Ex vivo long-term antimicrobial activity of modified catheters exceeded 4 weeks.
Immunocompromized patients suffering from cancer, transplantation, and dialysis patients with a long-term vascular access may mostly benefit from rifampicin-miconazole-releasing catheters.
抗菌中心静脉导管被认为是一种降低导管相关感染的装置。我们先前报告了一项研究，该研究纳入了 223 例成年外科患者，随机分为接受利福平-咪康唑负载中心静脉导管（CVC）（n=118）或标准 CVC（n=105）的患者。研究表明，抗菌 CVC 可显著降低导管定植（CC）和导管相关局部感染（CRI），即使在长期置管时也是如此。在这里，我们进一步评估了该研究，重点关注高危患者的可能获益。亚组分析显示，男性、超重和肿瘤患者的 CC 和 CRI 明显降低。CC 的重要协变量为皮肤定植，CRI 的重要协变量为肿瘤疾病。降低 CC 的优势比（OR）为 0.076（95%CI：0.016-0.360），癌症亚组的 CRI 从 26%降低至 2.3%（p=0.001）。改良导管的体外长期抗菌活性超过 4 周。
免疫功能低下的癌症患者、接受移植的患者和需要长期血管通路的透析患者可能从利福平-咪康唑释放导管中获益最大。
