Logghe C, Van Ossel C, D'Hoore W, Ezzedine H, Wauters G, Haxhe J J
Cliniques Universitaires Saint-Luc, Brussels, Belgium.
J Hosp Infect. 1997 Oct;37(2):145-56. doi: 10.1016/s0195-6701(97)90184-5.
It has been suggested that central venous catheters impregnated with antiseptics such as chlohexidine and silver-sulfadiazine reduce the risk of catheter-related bacteraemia in intensive care patients. Patients suffering from haematologic malignancy treated by chemotherapy through a central venous catheter are at even greater risk of catheter-related bacteraemia. A prospective double-blind randomized controlled trial was performed in order to investigate the effectiveness of chlorhexidine and silver-sulfadiazine impregnated catheters (CH-SS) in these patients. A total of 680 catheters (13,826 catheter days) were inserted, of which 338 were antiseptic impregnated. Bloodstream infection was observed in 105 cases with an overall risk of 7.6 per 1000 catheter days. Thirty-two infections (30.5%) were catheter-related, corresponding to a risk of 2.3 per 1000 catheter days. There was no statistically significant different between the overall rates of bloodstream infection for impregnated and non-impregnated catheters (14.5 vs. 16.3%). The incidence of catheter-related infection was also similar in both groups (5 vs. 4.4%) and there was no difference in the time of the onset of bacteraemia in the two groups. It is concluded that the use of CH-SS catheters in patients with haematologic malignancy reduces neither the overall risk of bloodstream infection, nor the catheter-related infection rate, nor the delay for the occurrence of infection.
有人提出，浸渍有洗必泰和磺胺嘧啶银等防腐剂的中心静脉导管可降低重症监护患者发生导管相关菌血症的风险。通过中心静脉导管接受化疗的血液系统恶性肿瘤患者发生导管相关菌血症的风险更高。为了研究浸渍有洗必泰和磺胺嘧啶银的导管（CH-SS）对这些患者的有效性，进行了一项前瞻性双盲随机对照试验。共插入了680根导管（13826个导管日），其中338根浸渍了防腐剂。观察到105例血流感染，总体风险为每1000个导管日7.6例。32例感染（30.5%）与导管相关，相当于每1000个导管日2.3例的风险。浸渍导管和未浸渍导管的总体血流感染率之间无统计学显著差异（14.5%对16.3%）。两组导管相关感染的发生率也相似（5%对4.4%），两组菌血症发生时间无差异。得出的结论是，在血液系统恶性肿瘤患者中使用CH-SS导管既不能降低总体血流感染风险，也不能降低导管相关感染率，也不能延迟感染的发生。
