Department of Medicine, Warren Alpert Medical School of Brown University, Brown, USA.
Antimicrob Resist Infect Control. 2012 Dec 3;1(1):40. doi: 10.1186/2047-2994-1-40.
Antimicrobial catheters have been utilized to reduce risk of catheter colonization and infection. We aimed to determine if there is a greater than expected risk of microorganism-specific colonization associated with the use of antimicrobial central venous catheters (CVCs).
We performed a meta-analysis of 21 randomized, controlled trials comparing the incidence of specific bacterial and fungal species colonizing antimicrobial CVCs and standard CVCs in hospitalized patients.
The proportion of all colonized minocycline-rifampin CVCs found to harbor Candida species was greater than the proportion of all colonized standard CVCs found to have Candida. In comparison, the proportion of colonized chlorhexidine-silver sulfadiazine CVCs specifically colonized with Acinetobacter species or diphtheroids was less than the proportion of similarly colonized standard CVCs. No such differences were found with CVCs colonized with staphylococci.
Commercially-available antimicrobial CVCs in clinical use may become colonized with distinct microbial flora probably related to their antimicrobial spectrum of activity. Some of these antimicrobial CVCs may therefore have limited additional benefit or more obvious advantages compared to standard CVCs for specific microbial pathogens. The choice of an antimicrobial CVC may be influenced by a number of clinical factors, including a previous history of colonization or infection with Acinetobacter, diphtheroids, or Candida species.
抗菌导管已被用于降低导管定植和感染的风险。我们旨在确定使用抗菌中心静脉导管（CVC）是否会增加与特定微生物定植相关的风险，超过预期。
我们对 21 项随机对照试验进行了荟萃分析，比较了住院患者中抗菌 CVC 和标准 CVC 定植特定细菌和真菌物种的发生率。
所有定植米诺环素-利福平 CVC 中发现的念珠菌种类的比例大于所有定植标准 CVC 中发现的念珠菌的比例。相比之下，定植氯己定-磺胺嘧啶银 CVC 中定植不动杆菌或类白喉菌的比例小于同样定植标准 CVC 的比例。在定植葡萄球菌的 CVC 中未发现这种差异。
临床使用的市售抗菌 CVC 可能会定植独特的微生物菌群，可能与其抗菌活性谱有关。与标准 CVC 相比，其中一些抗菌 CVC 对特定的微生物病原体可能具有有限的额外益处或更明显的优势。抗菌 CVC 的选择可能受到许多临床因素的影响，包括先前定植或感染不动杆菌、类白喉菌或念珠菌的病史。
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