Reduced Intravascular Catheter-related Infection by Routine Use of Antibiotic-bonded Catheters in a Surgical Intensive Care Unit

• Published in: Diagnostic microbiology and infectious disease 1998-03, Vol.30 (3), p.145-152
• Main Authors: Kamal, Gagan D., Divishek, Donna, Kumar, Girish C., Porter, Burdett R., Tatman, David J., Adams, John R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotic Prophylaxis; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Infections - microbiology; Bacterial Infections - prevention & control; Biological and medical sciences; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - methods; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - methods; Catheters, Indwelling - adverse effects; Cefazolin - therapeutic use; Female; Humans; Intensive Care Units; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Technology. Biomaterials. Equipments. Material. Instrumentation
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/S0732-8893(97)00215-0

We report a comparative analysis of intravascular catheter-related infection before and after routine use of antibiotic-bonded catheters in an intensive care unit. Cefazolin-bonded catheters were placed in patients requiring catheterization for at least 3 days, or with remote infection, standard catheters at other times. One thousand forty-five catheters (259 patients) over 6 months were compared with 801 (236 antibiotic-bonded, 565 standard) catheters (239 patients) the next 6 months. After use of antibiotic-bonded catheters, we found: 1.7% catheters infected versus 3.7% ( p = 0.01); catheter-associated bacteremia 0.1% versus 1.3% ( p < 0.005); catheter-related infection rate 4.39 versus 10.73 per 1000 patient days ( p < 0.005), and 5.06 versus 11.47 per 1000 catheter days ( p < 0.01); and cumulative risk of infection decreased ( p < 0.005). Antibiotic-bonded catheters were used with more remote infections (52% versus 27%, p < 0.001), had longer indwelling time (4.4 versus 3.1 days, p = 0.001), and more were inserted over a guide wire (66% vs. 28%, p < 0.001). In conclusion, routine use of antibiotic-bonded catheters was associated with a significant reduction in infectious complications.