Meta-analysis: Impact of catheter antimicrobial coating on species-specific risk of catheter colonization

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Intravenous literature: Novikov, A., Lam, M.Y., Mermel, L.A., Casey, A.L., Elliott, T.S. and Nightingale, P. (2012) Impact of catheter antimicrobial coating on species-specific risk of catheter colonization: a meta-analysis. Antimicrobial Resistance and Infection Control 2012, 1:40.

Abstract:

Methods: We performed a meta-analysis of 21 randomized, controlled trials comparing the incidence of specific bacterial and fungal species colonizing antimicrobial CVCs and standard CVCs in hospitalized patients.

Results: The proportion of minocycline-rifampin colonized CVCs that were colonized with Candida species was greater than the proportion associated with standard colonized CVCs. In comparison, the proportion of colonized chlorhexidine-silver sulfadiazine CVCs specifically
colonized with Acinetobacter species or diphtheroids was less than the proportion of similarly colonized standard CVCs. No such differences were found with CVCs colonized with staphylococci.

Conclusion: Commercially-available antimicrobial CVCs in clinical use may become colonized with distinct microbial flora probably related to their antimicrobial spectrum of activity. Some of these antimicrobial CVCs may therefore have limited additional benefit or more obvious advantages compared to standard CVCs for specific microbial pathogens. The choice of an antimicrobial CVC may be influenced by a number of clinical factors, including a previous history of colonization or infection with Acinetobacter, diphtheroids, or Candida species.

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