Critically ill patients ofttimes h...

Critically ill patients ofttimes have high mortality rates when they unfold nosocomial bloodstream infections. In addition, these infections have been shown to increase long durations of stay in intensive care units (ICUs) and to add substantially to the preciousness of care. One of the main sources of nosocomial bloodstream infections is intravascular catheters. A substantial number of nosocomial infections have been associated with catheter colonization, or the infections put in mind of that catheters are the source. Central venous catheters impregnated with minocycline and rifampin have been shown to make less nosocomial bloodstream infections. Studies have shown that catheter-related infections were 12 times les likely to appear with these impregnated catheters. However, despite this reduction in infection incidence, the use of these catheters may arise in an increase in multi-drug-resistant organisms. Hanna and colleagues assessed the impact of central venous catheters impregnated with minocycline and rifampin onward nosocomial bloodstream infections in critically ill patients.

This two-year prospective surveillance close attention included patients who were admitted to surgical and medical ICUs at a cancer center During the first year, central venous catheters without impregnated antibiotics were inserted; in the inferior year, patients were switched to catheters with minocycline and rifampin impregnated upon the outside and the inside of the lumen Standard sterile techniques were used during insertion, and care of the catheter site was performed by protocol. The decision to destroy and culture the catheter was made by way of each patient's primary care physician. consequence measures were nosocomial bloodstream infections, including vancomycin-resistant enterococcus (VRE); catheter-related infections; duration of ICU and hospital stays; and mortality in the ICU related to bloodstream infections.

During the first year, 1781 patients were admitted to the couple ICUs, while 2,349 patients were admitted during the inferior year. The demographics of the arranges in years 1 and 2 were not significantly different. The rate of nosocomial bloodstream infections in the medical and surgical ICUs dropp significantly during year 2 of the studious mood compared with year 1. In addition, the number of nosocomial VRE infections, the detail of ICU stay, and the detail of hospital stay decreased significantly after the use of antibiotic-impregnated catheters was introduced. The rate of catheter-related infections also decreased in year 2 of the research compared with year 1. charge analysis revealed that implementation of antibiotic-impregnated catheters saved the hospital $1450000 during the fiscal year.

The authors close that the use of antibiotic-impregnated central venous catheters in medical and surgical ICUs is associated with a significant decrease in nosocomial bloodstream infections. In addition, this intervention brings the development of VRE bacteremia, catheter-related infections, and duration of ICU and hospital stays.

Hanna HA, et al. Antibiotic-impregnated catheters associated with significant decrease in nosocomial and multidrug-resistant bacteremias in critically ill patients. Chest September 2003;124:1030-8

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