Catheter-Related Infections Clinical Trial
Official title:
Reduction of Catheter-Related Bloodstream Infections in Preterm Infants by the Use of Catheters With the AgION Antimicrobial System
The investigators assessed if use of AgION-impregnated umbilical catheters can decrease the occurrence of catheter-related bloodstream infections (CRBSI) in preterm infants.
Recently, a silver zeolite-impregnated catheter has been commercialized. This material,
namely the patented silver compound AgION™, releases antimicrobially active silver ions
which may help prevent catheter-related bloodstream infections CRBSIs which are frequent in
preterm infant.
The investigators hypothesized that the use of AgION-impregnated umbilical catheters could
decrease the occurrence of CRBSIs in preterm infants. To assess this hypothesis the
investigators carried out a randomized controlled study in which preterm infants needing an
umbilical vein catheter would received either an AgION catheter or a traditional
non-impregnated polyurethane catheter.
Infants with gestational age < 30 weeks were randomized to receive an AgION- impregnated or
non-impregnated polyurethane umbilical venous catheter (UVC) by opening sealed opaque
envelopes. The primary end point was the incidence of CRBSIs during the time the UVC was in
place.
The investigators studied 86 infants, 41 of whom received the AgION catheter and 45 the
non-impregnated catheter. During umbilical venous catheterization 2% of infants in the AgION
group developed CRBSI in comparison with 22% of infants in the control group (p=0.005). The
incidence density of CRBSIs during the study period was lower in infants who received AgION
catheters compared to the control group (2.1/1000 catheter days versus 25.8/1000 catheter
days; p<0.001). The occurrence of UVC colonization was similar in both groups. The
Kaplan-Meier estimates of the cumulative likelihood of being free of a CRBSI at each day of
UVC placement demonstrate the statistically significant (p=0.004) protective effect of AgION
impregnated catheters. Moreover, infants in the AgION group had shorter hospital stay
(p=0.04), and a lower case fatality rate due to BSI (p=0.01) than infants in the control
group.
AgION catheters were well tolerated and none of patients showed signs attributable to silver
toxicity.
Multivariate analysis demonstrated that non-impregnated catheter use (OR 12.5, 95% C.l.
2.06-75.9) and catheter placement for more than 7 days (OR 5.1, 95% C.l. 1.13-23.6)
increased the risk of developing a CRBSI in our population.
Conclusions. The AgION-impregnated UVCs were effective in decreasing the development of
CRBSIs in preterm infants compared to non-impregnated polyurethane UVCs.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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