REDUCING INFECTIONS ASSOCIATED WITH CENTRAL VENOUS CATHETERS

Central venous catheters (CVCs) are being used with increasing frequency. A major complication of their use is catheter-related septicemia, with a reported incidence as high as 18%. Several factors, including type of catheter and site of insertion, affect the rate of catheter-related infection. Attempts at reducing the incidence of infections have had variable results. In this issue Modak and Sampath describe a novel CVC impregnated with silver sulfadiazine and chlorhexidine. In a study in rats, the investigators demonstrated in vitro synergy of these 2 compounds against bacteria and, very importantly, against fungi. In vitro inhibition persisted even after 2 years of aging the catheter at room temperature. They also observed minimal development of bacterial resistance. This was in marked contrast to use of antibiotics, which resulted in a 40- to 100-fold increase in resistance.