Are Impregnated Catheters Better for Preventing CLABSI?
High level evidence demonstrates that using an antiseptic- or antimicrobial-impregnated central venous catheter (CVC) reduces the risk of CLABSI and catheter colonisation in hospitalised adult patients. These CVCs also reduce CLABSI risk in hospitalised paediatric patients, but the quality of the evidence is of moderate level.
In a recent update of clinical practice guidelines, Buetti and colleagues (2022) recommend antiseptic- or antimicrobial-impregnated CVCs as an additional approach to prevent CLABSI.
A CLABSI risk assessment should be conducted prior to implementing this infection prevention strategy. The take-home message is that antiseptic- and antimicrobial-impregnated catheters could be worthwhile if any of the following apply:
The hospital CLABSI rate is higher than acceptable, despite optimal compliance with CLABSI prevention bundles;
Patients with recurrent episodes of CLABSI and difficult IV access
Patients in whom developing a CLABSI would result to a high risk of severe consequences (e.g., those with a recently implanted prosthetic heart valve, or those receiving mechanical circulatory support such as extracorporeal membrane oxygenation).
References:
Buetti N, Marschall J, Drees M, Fakih MG, Hadaway L, Maragakis LL, et al. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update. Infection Control and Hospital Epidemiology. 2022;43(5):553-69. https://doi.org/10.1017/ice.2022.87