Catheters are the leading source of bloodstream infections for patients in the intensive care unit (ICU). Comprehensive unit-based programs have proven to be effective in decreasing catheter-related bloodstream infections (CR-BSIs). ICU rates of CR-BSI higher than 2 per 1,000 catheter-days are no longer acceptable.
The locally adapted list of preventive measures should include skin antisepsis with an alcoholic preparation, maximal barrier precautions, a strict catheter maintenance policy, and removal of unnecessary catheters. The development of new technologies capable of further decreasing the now low CR-BSI rate is a major challenge.
Recently, new materials that decrease the risk of skin-to-vein bacterial migration, such as new antiseptic dressings, were extensively tested. Antimicrobial-coated catheters can prevent CR-BSI but have a theoretical risk of selecting resistant bacteria. An antimicrobial or antiseptic lock may prevent bacterial migration from the hub to the bloodstream.
Jean-Francois Timsit, of Medical Polyvalent Intensive Care Unit, University Joseph Fourier, Albert Michallon Hospital in France, and colleagues, conducted a review the available knowledge about these new technologies. Their paper was printed in Annals of Intensive Care 2011.
Reference: Jean-Francois Timsit, Yohann Dubois, Clemence Minet, Agnes Bonadona, Maxime Lugosi, Claire Ara-Somohano, Rebecca Hamidfar-Roy and Carole Schwebel. New materials and devices for preventing catheter-related infections. Annals of Intensive Care 2011, 1:34 doi:10.1186/2110-5820-1-34.