A comparison between two types of central venous catheters in the prevention of catheter-related infections: the importance of performing all the relevant cultures

Objective: to determine the efficacy of double-lumen central venous catheters coated with chlorhexidine and silver-sulfadiazine in reducing the incidence of catheter-related infections. Design: a randomized controlled trial. Setting: medical-surgical intensive care unit of a 600-bed teaching hospital. Patients: adult patients who needed a central venous catheter in the subclavian vein. Intervention: patients received either a standard catheter (n = 46), or a chlorhexidine and silver-sulfadiazine-impregnated catheter (n = 48). Measurements: catheters were removed if there was no need for them anymore or if they were suspected as a cause of infection. Three parts of the catheter were cultured semi-quantitatively. Blood-, wound-, urine- and sputum-cultures were obtained on the day of catheter removal in order to allow a correct diagnosis of catheter-related bloodstream infection (CR-BSI). Results: in total 16 catheters were colonized (17%), six in the antiseptic-bonded catheter group (12%) and 10 in the stan...