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Antibiotic-impregnated catheters associated with significant decrease in nosocomial and multidrug-resistant

Hend A Hanna1, Issam I Raad, Brenda Hackett

  • 1Department of Infectious Diseases, Infection Control, and Employee Health (Unit 402), The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. hhanna@mdanderson.org

Chest
|September 13, 2003
PubMed
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Antibiotic-impregnated central venous catheters (CVCs) significantly reduced bloodstream infections (BSIs) and length of stay in intensive care units (ICUs). This intervention also led to substantial cost savings, improving patient outcomes in cancer care.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Hospital Epidemiology

Background:

  • Nosocomial bloodstream infections (BSIs) are a significant concern in intensive care units (ICUs), particularly for cancer patients.
  • Central venous catheters (CVCs) are essential for managing critically ill patients but are associated with an increased risk of infection.
  • Minimizing CVC-related infections is crucial for improving patient outcomes and reducing healthcare costs.

Purpose of the Study:

  • To assess the effectiveness of central venous catheters (CVCs) impregnated with minocycline and rifampin in reducing nosocomial bloodstream infections (BSIs).
  • To evaluate the impact of these impregnated CVCs on patient morbidity and mortality in cancer patients within the ICU setting.
  • To determine the economic impact of using antibiotic-impregnated CVCs in a tertiary care hospital.

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Main Methods:

  • A prospective surveillance study was conducted over two fiscal years (FY 1998 and FY 1999).
  • The study involved cancer patients in the medical ICU (MICU) and surgical ICU (SICU) of a tertiary care hospital.
  • The intervention involved the introduction of minocycline-rifampin impregnated CVCs at the beginning of FY 1999.

Main Results:

  • Nosocomial BSI rates significantly decreased in both MICU (8.3 to 3.5 per 1,000 patient-days) and SICU (4.8 to 1.3 per 1,000 patient-days) after the introduction of impregnated CVCs (p < 0.01 for both).
  • Significant reductions were observed in vancomycin-resistant enterococcus (VRE) bacteremia (p = 0.004) and catheter-related infections (p = 0.02).
  • Length of stay in the ICU and overall hospitalization duration decreased significantly, leading to estimated net savings of at least $1,450,000 in FY 1999.

Conclusions:

  • The use of minocycline-rifampin impregnated CVCs is associated with a significant reduction in nosocomial BSIs, including VRE bacteremia and catheter-related infections.
  • This intervention led to decreased lengths of hospital and ICU stays for cancer patients.
  • Antibiotic-impregnated CVCs represent an effective strategy for infection control and cost reduction in critical care settings.