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World J Crit Care Med. May 4, 2016; 5(2): 137-142
Published online May 4, 2016. doi: 10.5492/wjccm.v5.i2.137
Antimicrobial-impregnated catheters for the prevention of catheter-related bloodstream infections
Leonardo Lorente
Leonardo Lorente, Intensive Care Unit, Hospital Universitario de Canarias, 38320 La Laguna, Santa Cruz de Tenerife, Spain
Author contributions: The author solely contributed to this paper.
Conflict-of-interest statement: None declared.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leonardo Lorente, MD, PhD, Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, 38320 La Laguna, Santa Cruz de Tenerife, Spain. lorentemartin@msn.com
Telephone: +34-922-678000 Fax: +34-922-647112
Received: June 1, 2015
Peer-review started: June 7, 2015
First decision: August 16, 2015
Revised: December 21, 2015
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: May 4, 2016
Processing time: 329 Days and 20.1 Hours
Abstract

Central venous catheters are commonly used in critically ill patients. Such catheterization may entail mechanical and infectious complications. The interest in catheter-related infection lies in the morbidity, mortality and costs that it involved. Numerous contributions have been made in the prevention of catheter-related infection and the current review focuses on the possible current role of antimicrobial impregnated catheters to reduce catheter-related bloodstream infections (CRBSI). There is evidence that the use of chlorhexidine-silver sulfadiazine (CHSS), rifampicin-minocycline, or rifampicin-miconazol impregnated catheters reduce the incidence of CRBSI and costs. In addition, there are some clinical circumstances associated with higher risk of CRBSI, such as the venous catheter access and the presence of tracheostomy. Current guidelines for the prevention of CRBSI recommended the use of a CHSS or rifampicin-minocycline impregnated catheter in patients whose catheter is expected to remain in place > 5 d and if the CRBSI rate has not decreased after implementation of a comprehensive strategy to reduce it.

Keywords: Catheter; Venous; Prevention; Impregnated; Bloodstream

Core tip: The catheter-related bloodstream infections (CRBSI) are associated with an increase of mortality and costs. Thus it is necessary to adopt preventive measures to reduce it. In my opinion of view, the use of antimicrobial impregnated catheters could be considered in some clinical circumstances associated with higher risk of CRBSI, such as vascular accesses with higher risk of CRBSI (such as internal jugular venous site with tracheostomy or femoral venous site) or patients with higher risk of CRBSI (such as immunocompromised patients or patients with disorders of skin integrity).