Intravenous literature: Antonelli, M., De Pascale, G., Ranieri, V.M., Pelaia, P., Tufano, R., Piazza, O., Zangrillo, A., Ferrario, A., De Gaetano, A., Guaglianone, E. and Donelli, G. (2012) Comparison of triple-lumen central venous catheters impregnated with silver nanoparticles (AgTive) vs conventional catheters in intensive care unit patients. The Journal of Hospital Infection. Aug 28. [Epub ahead of print].
BACKGROUND: Silver-impregnated central venous catheters (CVCs) have been proposed as a means for preventing CVC colonization and related bloodstream infections (CRBSIs).
AIM: To evaluate the efficacy of CVCs impregnated with silver nanoparticles in a large group of critically ill patients.
METHODS: A prospective, randomized clinical trial was conducted in five intensive care units (ICUs). Three hundred and thirty-eight adult patients requiring CVCs between April 2006 and November 2008 were randomized to receive AgTive silver-nanoparticle-impregnated (SC) or conventional (CC) CVCs. Primary endpoints were CVC colonization (growth of â‰¥15 colony-forming units from the catheter tip) and incident CRBSIs (meeting the definitions of the Centers for Disease Control and Prevention). Infection-free time (days from initial CVC insertion to initial blood culture positivity) and ICU mortality rates were measured as secondary endpoints.
FINDINGS: The SC group (N = 135) and CC group (N = 137) were similar in terms of clinical and laboratory parameters at baseline, reasons for ICU admission, complications during CVC insertion, and total time with CVC (mean Â± standard deviation; SC 13 Â± 24 vs CC 15 Â± 37 days). No significant intergroup differences were found in CVC colonization rates (SC 32.6% vs CC 30%; P = 0.7), CRBSI incidence rates (3.36 infections per 1000 catheter-days in both groups), infection-free times (SC 13 Â± 34 vs CC 12 Â± 12 days; P = 0.85) or ICU mortality (SC 46% vs CC 43%; P = 0.7).
CONCLUSION: In critically ill patients, use of AgTive silver-nanoparticle-impregnated CVCs had no significant effect on CVC colonization, CRBSI incidence or ICU mortality. These CVCs cannot be recommended as an adjunctive tool for control of CRBSIs.