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Subclavian Hemodialysis Catheter Infections: A Prospective, Randomized Trial of an Attachable Silver-impregnated Cuff for Prevention of Catheter-related Infections

Published online by Cambridge University Press:  02 January 2015

Philip J. Dahlberg ,
William A. Agger ,
James R. Singer ,
Wilfrido R. Yutuc ,
Kermit L. Newcomer ,
Ana Schaper  and
Brenda L. Rooney
Philip J. Dahlberg
Affiliation:
Section of Nephrology, Gundersen Clinic, Ltd, La Crosse, Wisconsin
William A. Agger
Affiliation:
Section of Infectious Diseases, Gundersen Clinic, Ltd, La Crosse, Wisconsin
James R. Singer
Affiliation:
Section of Nephrology, Gundersen Clinic, Ltd, La Crosse, Wisconsin
Wilfrido R. Yutuc
Affiliation:
Section of Nephrology, Gundersen Clinic, Ltd, La Crosse, Wisconsin
Kermit L. Newcomer
Affiliation:
Section of Nephrology, Gundersen Clinic, Ltd, La Crosse, Wisconsin
Ana Schaper
Affiliation:
Gundersen Medical Foundation, Gundersen Clinic, Ltd, La Crosse, Wisconsin
Brenda L. Rooney
Affiliation:
Gundersen Medical Foundation, Gundersen Clinic, Ltd, La Crosse, Wisconsin
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Abstract

Objective:

To determine if an attachable silver-impregnated cuff is effective in reducing subclavian hemodialysis catheter-related infections.

Design:

Prospective, randomized, nonblinded study.

Setting:

Community teaching hospital.

Patients:

One hundred one acute and chronic renal failure patients requiring subclavian venipuncture and catheterization. After randomization, 47 patients underwent subclavian catheterization with a silver-impregnated cuff (Ag-CC), and 54 patients had routine catheter (RC) placements.

Measurements:

Multiple presumed predictor variables for catheter-related infections, exit site infection rate, bacteremia rates, and semiquantitative cultures of all catheters.

Results:

There were no significant differences between the AG-CC and the RC groups for catheter colonization, exit site infection, catheter sepsis, any catheter-related infections, or the incidence of infections within the first 7 or 14 days. Although the differences did not achieve statistical significance, the RC group was more likely to experience catheter colonization (20.4% versus 14.9%) and exit site infection (5.6% versus 2.1%). However, the RC group contained nearly twice as many intensive care (ICU) patients (44% versus 23%; P=.027), and ICU subjects were twice as likely to acquire catheter infection (P<.002).

Conclusions:

Although the sample size was insufficient to exclude Type 2 errors, it appears that the attachable silver-impregnated cuff did not reduce subclavian catheter-related infections in our patient population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 9 , September 1995 , pp. 506 - 511
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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