Antimicrobial-impregnated discs for prevention of intravenous catheter-related infections

Kelly R. Daniels, Christopher R. Frei

    Research output: Contribution to journalReview article

    2 Scopus citations

    Abstract

    Problem statement: Healthcare-associated infections are the 5th leading cause of death in the United States. Catheter-Related Bloodstream Infections (CRBSIs) comprise 14% of all health care associated infections and contribute to increased mortality and financial costs. Antimicrobial impregnated sponge discs to be used surrounding the catheter insertion site are a newer addition to the options available for the prevention of catheter-related infections. Approach: This review critically appraises the literature regarding the utility of antimicrobial-impregnated discs. We performed a literature search using the MEDLINE (1948-November 2011) database. Only controlled clinical trials were included and the electronic database search was performed using the following MeSH and keyword search terms: ("Biopatch" or "chlorhexidine") and ("dressing" or "sponge") and ("catheter"). Results: Our search yielded eight trials. Chlorhexidine-impregnated discs are effective in preventing catheter colonization in hospitalized patients and outpatients; however, effectiveness in preventing CRBSIs may be limited to hospitalized, critically ill patients. Although many studies have evaluated the effectiveness of several pharmaceutical agents for the prevention of catheter-related infections, there are still significant gaps in the literature regarding these infections, including the effectiveness of Polyhexamethylene Biguanide (PHMB)-impregnated discs and the cost-effectiveness of PHMB impregnated discs compared to chlorhexidine-impregnated discs. It is also unclear if antimicrobial impregnated discs are effective in specific populations, like in outpatients, patients at high risk compared to low risk patients and patients with long-term catheters. Conclusion: Chlorhexidine impregnated discs should be utilized for the duration of catheterization in high risk, critically ill patients and in hospitals where catheter-related infection rates are persistently high despite other preventative strategies. Futher investigation of the effectiveness of these discs in other populations and of other antimicrobial-impregnated discs is needed.

    Original languageEnglish (US)
    Pages (from-to)50-59
    Number of pages10
    JournalAmerican Journal of Infectious Diseases
    Volume8
    Issue number1
    StatePublished - Mar 7 2012

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    Keywords

    • Catheter-related bloodstream infections (CRBSIs)
    • Central venous catheters (CVCs)
    • Coagulase-negative staphylococcus (CoNS)
    • National institutes of health (NIH)
    • Polyhexamethylene biguanide (PHMB)
    • United states (US)

    ASJC Scopus subject areas

    • Infectious Diseases

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