Prevention of Bloodstream Infections With Central Venous Catheters Treated With Anti-Infective Agents Depends on Catheter Type and Insertion Time: Evidence From a Meta-Analysis
| Autor: | Bernhard Walder, Martin R. Tramèr, Didier Pittet |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Catheterization Central Venous Time Factors Epidemiology medicine.drug_class Administration Topical Bacteremia Cross Infection/ prevention & control Bacterial Adhesion Catheters Indwelling/ microbiology Sulfadiazine Catheters Indwelling Insertion time Antiseptic Anti-Infective Agents Coated Materials Biocompatible medicine Humans Antibacterial agent Randomized Controlled Trials as Topic ddc:616 Cross Infection business.industry Bacteremia/ prevention & control Bacterial Adhesion/drug effects Odds ratio medicine.disease Confidence interval Surgery Catheter Anti-Infective Agents/ administration & dosage Infectious Diseases Treatment Outcome Catheterization Central Venous/ instrumentation business medicine.drug |
| Zdroj: | Infection Control and Hospital Epidemiology, Vol. 23, No 12 (2002) pp. 748-756 |
| ISSN: | 0195-9417 0899-823X |
| Popis: | Objective:To test the evidence that the risk of infection related to central venous catheters (CVCs) is decreased by anti-infective coating or cuffing.Design:Systematic review of randomized, controlled trials comparing anti-infective with inactive (control) CVCs.Interventions:Average insertion times were taken as a measurement of the length of insertion. Dichotomous data were combined using a fixed effect model and expressed as odds ratio (OR) with 95% confidence interval (CI95).Results:Two trials on antibiotic coating (343 CVCs) had an average insertion time of 6 days; the risk of BSI decreased from 5.1% with control to 0% with anti-infective catheters. There were no trials with longer average insertion times. In three trials on silver collagen cuffs (422 CVCs), the average insertion time ranged from 5 to 8.2 days (median, 7 days); the risk of BSI was 5.6% with control and 3.2% with anti-infective catheters. In another trial on silver collagen cuffs (101 CVCs), the average insertion time was 38 days; the risk of BSI was 3.7% with control and 4.3% with anti-infective catheters. In five trials on chlorhexidine-silver sulfadiazine coating (1,269 CVCs), the average insertion time ranged from 5.2 to 7.5 days (median, 6 days); the risk of BSI decreased from 4.1% with control to 1.9% with anti-infective catheters. In five additional trials on chlorhexidine–silver sulfadiazine coating (1,544 CVCs), the average insertion time ranged from 7.8 to 20 days (median, 12 days); the risk of BSI was 4.5% with control and 4.2% with anti-infective catheters.Conclusions:Antibiotic and chlorhexidine–silver sulfadiazine coatings are anti-infective for short (approximately 1 week) insertion times. For longer insertion times, there are no data on antibiotic coating, and there is evidence of lack of effect for chlorhexidine-silver sulfadiazine coating. For silver-impregnated collagen cuffs, there is evidence of lack of effect for both short- and long-term insertion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|