Arvaniti, K., Lathyris, D., Clouva-Molyvdas, P., Haidich, A.B., Mouloudi, E., Synnefaki, E., . . . Catheter-Related Infections in ICU (CRI-ICU) Group. (2012). Comparison of oligon catheters and chlorhexidine-impregnated sponges with standard multilumen central venous catheters for prevention of associated colonization and infections in intensive care unit patients: A multicenter, randomized, controlled study. Critical Care Medicine, 40, 420–429. 

To evaluate the effectiveness of oligon central venous catheters (CVC) and chlorhexidine biopatch to reduce CVC-related infections. Oligon catheters are impregnated with antimicrobial silver, platinum, and carbon.

Patients were randomized to receive either a standard polyurethane catheter, a standard catheter plus biopatch, or an oligon catheter. All catheters were triple lumen. Standard maximum barrier insertion techniques were used, and dressing change frequency was every three days with a transparent dressing. Those getting the biopatch had the biopatch changed with regular dressing changes. The primary study endpoint was catheter colonization. A decision to remove the catheter was made by individual physicians.

• N = 376; 465 in intention to treat analysis
• MEDIAN AGE = 59 years
• AGE RANGE = 32–73 years
• MALES: 69.7%, FEMALES: 30.3%
• CURRENT TREATMENT: Immunotherapy
• KEY DISEASE CHARACTERISTICS: Overall, 7% of the sample had cancer.
• OTHER KEY SAMPLE CHARACTERISTICS: 96% of patients were in the ICU for mechanical ventilation.

• SITE: Multi-site   
• SETTING TYPE: Inpatient    
• LOCATION: Greece

• Three-group randomized, controlled trial (RCT)

• Catheter colonization defined as 10³ or greater colony forming units ml of catheter tip
• Catheter-related infection (CRI) defined as positive colonization and clinical evidence of sepsis with the same organism and no other clinical site for infection
• Central line–associated bloodstream infection (CLABSI) defined as CRI plus one positive peripheral blood culture with the same organism as isolated from the catheter tip

There were no differences in catheter colonization rates, CRI, or CLABSI between groups. There were no differences between groups in number of catheter days, CLABSI incidence per 1,000 catheter days, or other factors potentially associated with development of CLABSI. Analysis showed that use of jugular or femoral insertion site and cancer diagnosis were significantly associated with development of catheter colonization (p < 0.05).

Findings did not support efficacy of BIOPATCH dressings or antimicrobial catheters for prevention of catheter-related colonization or infections.

• Risk of bias (no blinding)
• Risk of bias (sample characteristics)
• Key sample group differences that could influence results
• The study was underpowered. Patients receiving BIOPATCH dressing and impregnated catheters had significantly lower proportion of patients. No data regarding actual adherence to insertion and dressing change protocols existed.

Findings did not show efficacy of chlorhexidine-BIOPATCH CVC dressings or antimicrobial impregnated short-term catheters to prevent catheter colonization and related CVC-infection related outcomes.