A Prospective, Randomized Evaluation of the Effect of Silver Impregnated Subcutaneous Cuffs for Preventing Tunneled Chronic Venous Access Catheter Infections in Cancer Patients

Groeger, Jeffrey S.; Lucas, Alice; Coit, Daniel G.; LaQuaglia, Michael J.; Brown, Arthur E.; Turnbull, A. D.; Exelby, Philip R.

doi:10.1097/00000658-199308000-00014

Cited by 124 publications

(41 citation statements)

References 18 publications

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“…Totally implantable venous access devices have proved to be less susceptible to complications than tunneled catheter systems [10, 12, 13]. The reported event rate ranged from 0.45 to 1.16 events/1,000 port days [5,6,7,8,9,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Lack of immunocompetence is a main risk factor for infections, as seen in patients with HIV, who develop significantly more port infections than cancer patients (1.5 vs. 0.96 infections/1,000 port days) [26]. The pathogens described in the literature are predominantly Gram-positive cocci with coagulase-negative Staphylococcus accounting for 50% of all cases [13,26,27,28]. Our treatment usually comprised the removal of the colonized port system.…”

Section: Discussionmentioning

confidence: 99%

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Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Samaras¹,

Dold²,

Braun

et al. 2008

Oncology

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Background: We assessed longevity and complications of totally implantable venous access devices in oncology patients. Methods: 197 patients received a total of 201 port devices via the subclavian vein for delivery of chemotherapy between January 1, 2005, and December 31, 2006. We reviewed the patient charts for port-related complications and risk factors until July 31, 2007. Results:A total of 47,781 catheter days were analyzed (median, 175 days; range, 1–831). Forty-six different complications occurred (0.96 complications/1,000 catheter days). The only risk factor significantly associated with a higher complication rate was younger age. Older patients had a lower risk for developing complications with a risk reduction of 2.4% for each year. There were no differences regarding underlying tumor, gender, access side, method of placement (subclavian/cephalic vein) or implanting team (thoracic versus visceral surgery). A trend was seen for shorter port longevity in hematologic patients compared to oncologic patients (p = 0.059). The former developed significantly more port-associated infections than solid tumor patients [11/53 cases (21%) versus 2/148 cases (1.4%); p < 0.0001]. Conclusions: Port-associated infections were mostly observed in younger patients with hematologic neoplasms. Prospective trials should be performed to evaluate the benefit of a prophylactic antimicrobial lock in these selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Samaras¹,

Dold²,

Braun

et al. 2008

Oncology

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“…The ionic silver provides antimicrobial activity and the cuff provides a mechanical barrier to the migration of microorganisms along the external surface of the catheter. In studies of catheters left in place 120 days, the cuff failed to reduce the incidence of CRBSI [94,95]. Two other studies of short-term catheters could not demonstrate efficacy because of the minimal number of CRBSIs observed [93,96].…”

Section: Antimicrobial/antiseptic Impregnated Catheters and Cuffsmentioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

635

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…21 If there was a suspicion of bacteremia, peripheral venous blood cultures were obtained and sent to the hospital microbiology laboratory. For the coated CVC, the remaining portions were sent to a research microbiology laboratory, where they were flushed with nonbacteriostatic saline solution, cut, measured, weighed, and placed on Mueller-Hinton agar plates inoculated with a suspension (0.5 McFarland standard or approximately 1.5ϫ10 8 CFUs/ mL) of Staphylococcus aureus, which has been used in an animal model of catheter infection 11,13 and of Enterococcus (a blood isolate from a patient). The plates were incubated for 24 hours at 35°C in ambient air.…”

Section: Culturesmentioning

confidence: 99%

Influence of Triple-Lumen Central Venous Catheters Coated With Chlorhexidine and Silver Sulfadiazine on the Incidence of Catheter-Related Bacteremia

Heard¹,

Wagle²,

Vijayakumar³

et al. 1998

Arch Intern Med

209

117

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A Prospective, Randomized Evaluation of the Effect of Silver Impregnated Subcutaneous Cuffs for Preventing Tunneled Chronic Venous Access Catheter Infections in Cancer Patients

Abstract: The study indicated no effect of a silver-impregnated cuff in decreasing the incidence of catheter-related bacteremias/fungemias, tunnel infections, or the spectrum of causative microorganisms involved in cancer patients with tunneled chronic venous access catheters.

Cited by 124 publications

References 18 publications

Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Guidelines for the prevention of intravascular catheter-related infections

Influence of Triple-Lumen Central Venous Catheters Coated With Chlorhexidine and Silver Sulfadiazine on the Incidence of Catheter-Related Bacteremia

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