洗必泰-磺胺嘧啶银或利福平-咪康唑浸渍的静脉导管降低导管相关血流感染风险的效果相似。

Chlorhexidine-silver sulfadiazine- or rifampicin-miconazole-impregnated venous catheters decrease the risk of catheter-related bloodstream infection similarly.

作者信息

Lorente Leonardo, Lecuona María, Jiménez Alejandro, Raja Lorena, Cabrera Judith, Gonzalez Oswaldo, Diosdado Sara, Marca Lucía, Mora María L

机构信息

Department of Critical Care, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.

Department of Microbiology and Infection Control, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.

出版信息

Am J Infect Control. 2016 Jan 1;44(1):50-3. doi: 10.1016/j.ajic.2015.08.014. Epub 2015 Sep 26.

DOI:10.1016/j.ajic.2015.08.014

PMID:26412482

Abstract

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.

摘要

背景

本研究的目的是比较使用第二代洗必泰-磺胺嘧啶银（CHSS）浸渍导管、利福平-咪康唑（RM）浸渍导管和标准导管时导管相关血流感染（CRBSI）的发生率。

方法

对入住重症监护病房并在股静脉通路中接受CHSS、RM或标准导管的患者进行回顾性研究。

结果

在2061天内，245例使用标准导管的患者中有18例被诊断为CRBSI；在1489天内，169例使用CHSS浸渍导管的患者中CRBSI为零；在2009天内，227例使用RM浸渍导管的患者中CRBSI也为零。与使用CHSS和RM浸渍导管的患者相比，使用标准导管的患者CRBSI发生率更高（分别为7.3%、0%和0%；P <.001），CRBSI的发病密度也更高（分别为每1000导管日8.7、0和0；P <.001）。我们通过精确泊松回归发现，在控制导管留置时间的情况下，标准导管与CRBSI发生率高于CHSS浸渍导管（P <.001）和RM浸渍导管（P <.001）相关。我们通过生存分析发现，标准导管与无CRBSI时间低于CHSS浸渍导管（P <.001）和RM浸渍导管（P <.001）相关。