Antimicrobial-impregnated Central Venous Catheters for Prevention of Catheter-related Bloodstream Infection in Newborn Infants

Overview

Journal Cochrane Database Syst Rev

Publisher Wiley

Specialties General Medicine
Health Services

Date 2015 Sep 28

PMID 26409791

Citations 12

Authors

Munisha Balain

Sam J Oddie

William McGuire

Affiliations

Soon will be listed here.

Abstract

Background: Central venous catheter-related bloodstream infection is an important cause of mortality and morbidity in newborn infants cared for in neonatal units. Potential strategies to prevent these infections include the use of central venous catheters impregnated with antimicrobial agents.

Objectives: To determine the effect of antimicrobial-impregnated central venous catheters in preventing catheter-related bloodstream infection in newborn infants.

Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 8), MEDLINE (1966 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), conference proceedings and previous reviews.

Selection Criteria: Randomised or quasi-randomised controlled trials comparing central venous catheters impregnated or coated with any antibiotic or antiseptic versus central venous catheters without antibiotic or antiseptic coating or impregnation in newborn infants.

Data Collection And Analysis: We extracted data using the standard methods of the Cochrane Neonatal Group, with independent evaluation of risk of bias and data extraction by two review authors.

Main Results: We found only one small trial (N = 98). This trial found that silver zeolite-impregnated umbilical venous catheters reduced the incidence of bloodstream infection in very preterm infants (risk ratio 0.11, 95% confidence interval 0.01 to 0.87; risk difference -0.17, 95% CI -0.30 to -0.04; number needed to treat for benefit 6, 95% CI 3 to 25].

Authors' Conclusions: Although the data from one small trial indicates that antimicrobial-impregnated central venous catheters might prevent catheter-related bloodstream infection in newborn infants, the available evidence is insufficient to guide clinical practice. A large, simple and pragmatic randomised controlled trial is needed to resolve on-going uncertainty.

Citing Articles

Incorporating anti-infective drugs into peripherally inserted catheters does not reduce infection rates in neonates.

Koppitz J, Ascherl R, Thome U, Pulzer F Front Pediatr. 2024; 11:1255492.

PMID: 38250594 PMC: 10796449. DOI: 10.3389/fped.2023.1255492.

Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study.

Bayoumi M, van Rens M, Chandra P, Masry A, DSouza S, Khalil A Front Pediatr. 2022; 10:1012800.

PMID: 36507144 PMC: 9730802. DOI: 10.3389/fped.2022.1012800.

Umbilical Venous Catheter Update: A Narrative Review Including Ultrasound and Training.

DAndrea V, Prontera G, Rubortone S, Pezza L, Pinna G, Barone G Front Pediatr. 2022; 9:774705.

PMID: 35174113 PMC: 8841780. DOI: 10.3389/fped.2021.774705.

Antimicrobial-impregnated central venous catheters for preventing neonatal bloodstream infection: the PREVAIL RCT.

Gilbert R, Brown M, Faria R, Fraser C, Donohue C, Rainford N Health Technol Assess. 2020; 24(57):1-190.

PMID: 33174528 PMC: 7681353. DOI: 10.3310/hta24570.

Rapid Emergence of Multidrug-Resistance among Gram Negative Isolates at a Tertiary Pediatric and Maternity Hospital in Ulaanbaatar, Mongolia.

Felsenstein S, Bira S, Altanmircheg N, Shonkhuuz E, Ochirpurev A, Warburton D Cent Asian J Glob Health. 2020; 9(1):e371.

PMID: 33062401 PMC: 7538878. DOI: 10.5195/cajgh.2020.371.

References

Hoang V, Sills J, Chandler M, Busalani E, Clifton-Koeppel R, Modanlou H . Percutaneously inserted central catheter for total parenteral nutrition in neonates: complications rates related to upper versus lower extremity insertion. Pediatrics. 2008; 121(5):e1152-9. DOI: 10.1542/peds.2007-1962. View

Gilbert R, Harden M . Effectiveness of impregnated central venous catheters for catheter related blood stream infection: a systematic review. Curr Opin Infect Dis. 2008; 21(3):235-45. DOI: 10.1097/QCO.0b013e3282ffd6e0. View

Tambe S, Sampath L, Modak S . In vitro evaluation of the risk of developing bacterial resistance to antiseptics and antibiotics used in medical devices. J Antimicrob Chemother. 2001; 47(5):589-98. DOI: 10.1093/jac/47.5.589. View

Garland J, Alex C, Sevallius J, Murphy D, Good M, Volberding A . Cohort study of the pathogenesis and molecular epidemiology of catheter-related bloodstream infection in neonates with peripherally inserted central venous catheters. Infect Control Hosp Epidemiol. 2008; 29(3):243-9. DOI: 10.1086/526439. View

Demetriades A, Bassi S . Antibiotic resistant infections with antibiotic-impregnated Bactiseal catheters for ventriculoperitoneal shunts. Br J Neurosurg. 2011; 25(6):671-3. DOI: 10.3109/02688697.2011.575478. View

Aslam S, Darouiche R . Prolonged bacterial exposure to minocycline/rifampicin-impregnated vascular catheters does not affect antimicrobial activity of catheters. J Antimicrob Chemother. 2007; 60(1):148-51. DOI: 10.1093/jac/dkm173. View

Bassler D, Stoll B, Schmidt B, Asztalos E, Roberts R, Robertson C . Using a count of neonatal morbidities to predict poor outcome in extremely low birth weight infants: added role of neonatal infection. Pediatrics. 2009; 123(1):313-8. PMC: 2829863. DOI: 10.1542/peds.2008-0377. View

Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S . An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006; 355(26):2725-32. DOI: 10.1056/NEJMoa061115. View

Wirtschafter D, Pettit J, Kurtin P, Dalsey M, Chance K, Morrow H . A statewide quality improvement collaborative to reduce neonatal central line-associated blood stream infections. J Perinatol. 2009; 30(3):170-81. DOI: 10.1038/jp.2009.172. View

10.

Muttaiyah S, Ritchie S, John S, Mee E, Roberts S . Efficacy of antibiotic-impregnated external ventricular drain catheters. J Clin Neurosci. 2010; 17(3):296-8. DOI: 10.1016/j.jocn.2009.06.016. View

11.

Stewart P, Costerton J . Antibiotic resistance of bacteria in biofilms. Lancet. 2001; 358(9276):135-8. DOI: 10.1016/s0140-6736(01)05321-1. View

12.

Payne N, Carpenter J, Badger G, Horbar J, Rogowski J . Marginal increase in cost and excess length of stay associated with nosocomial bloodstream infections in surviving very low birth weight infants. Pediatrics. 2004; 114(2):348-55. DOI: 10.1542/peds.114.2.348. View

13.

Mahieu L, De Dooy J, Lenaerts A, Ieven M, De Muynck A . Catheter manipulations and the risk of catheter-associated bloodstream infection in neonatal intensive care unit patients. J Hosp Infect. 2001; 48(1):20-6. DOI: 10.1053/jhin.2000.0930. View

14.

Isaacs D . A ten year, multicentre study of coagulase negative staphylococcal infections in Australasian neonatal units. Arch Dis Child Fetal Neonatal Ed. 2003; 88(2):F89-93. PMC: 1721527. DOI: 10.1136/fn.88.2.f89. View

15.

Stevens K, Croes S, Boersma R, Stobberingh E, van der Marel C, van der Veen F . Hydrophilic surface coatings with embedded biocidal silver nanoparticles and sodium heparin for central venous catheters. Biomaterials. 2010; 32(5):1264-9. DOI: 10.1016/j.biomaterials.2010.10.042. View

16.

Brito C, Brito D, Abdallah V, Gontijo Filho P . Occurrence of bloodstream infection with different types of central vascular catheter in critically neonates. J Infect. 2009; 60(2):128-32. DOI: 10.1016/j.jinf.2009.11.007. View

17.

Miller M, Griswold M, Mitchell Harris 2nd J, Yenokyan G, Huskins W, Moss M . Decreasing PICU catheter-associated bloodstream infections: NACHRI's quality transformation efforts. Pediatrics. 2010; 125(2):206-13. DOI: 10.1542/peds.2009-1382. View

18.

Halton K, Cook D, Whitby M, Paterson D, Graves N . Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision. Crit Care. 2009; 13(2):R35. PMC: 2689469. DOI: 10.1186/cc7744. View

19.

Mahieu L, De Dooy J, De Muynck A, Van Melckebeke G, Ieven M, Van Reempts P . Microbiology and risk factors for catheter exit-site and -hub colonization in neonatal intensive care unit patients. Infect Control Hosp Epidemiol. 2001; 22(6):357-62. DOI: 10.1086/501913. View

20.

Vanholder R, Canaud B, Fluck R, Jadoul M, Labriola L, Marti-Monros A . Catheter-related blood stream infections (CRBSI): a European view. Nephrol Dial Transplant. 2010; 25(6):1753-6. DOI: 10.1093/ndt/gfq205. View