Effect of chlorhexidine/silver sulfadiazine-impregnated central venous catheters in an intensive care unit with a low blood stream infection rate after implementation of an educational program: a before-after trial

Surg Infect (Larchmt). 2007 Aug;8(4):445-54. doi: 10.1089/sur.2006.073.


Background: Current guidelines recommend using antiseptic- or antibiotic-impregnated central venous catheters (CVCs) if, following a comprehensive strategy to prevent catheter-related blood stream infection (CR-BSI), infection rates remain above institutional goals based on benchmark values. The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate.

Methods: Pre-intervention and post-intervention observational study in a 24-bed surgical/trauma/burn ICU from October, 2002 to August, 2005. All patients requiring CVC placement after March, 2004 had a chlorhexidine/silver sulfadiazine-impregnated catheter inserted (post-intervention period).

Results: Twenty-three CR-BSIs occurred in 6,960 catheter days (3.3 per 1,000 catheter days)during the 17-month control period. After introduction of chlorhexidine/silver sulfadiazine-impregnated catheters, 16 CR-BSIs occurred in 7,732 catheter days (2.1 per 1,000 catheter days; p = 0.16). The average length of time required for an infection to become established after catheterization was similar in the two groups (8.4 vs. 8.6 days; p = 0.85). Chlorhexidine/silver sulfadiazine-impregnated catheters did not result in a statistically significant change in the microbiological profile of CR-BSIs, nor did they increase the incidence of resistant organisms.

Conclusions: Although chlorhexidine/silver sulfadiazine-impregnated catheters are useful in specific patient populations, they did not result in a statistically significant decrease in the CR-BSI rate in this study, beyond what was achieved with education alone.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents, Local / administration & dosage*
  • Bacteremia / etiology
  • Bacteremia / prevention & control*
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheters, Indwelling / adverse effects
  • Catheters, Indwelling / microbiology*
  • Chlorhexidine / administration & dosage
  • Cross Infection / prevention & control*
  • Female
  • Fungemia / etiology
  • Fungemia / prevention & control
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Silver Sulfadiazine / administration & dosage


  • Anti-Infective Agents, Local
  • Chlorhexidine
  • Silver Sulfadiazine