Effectiveness of antibiotic-impregnated central venous catheters in reducing catheter-related bloodstream infections

Abstract

Overview of the topic: Catheter-related bloodstream infections (CRBSI) are described as the presence of bacteraemia emerging from an intravenous catheter, most frequently associated with central venous catheters (CVCs) (Yücel et al., 2004). CRBSIs can increase the length of hospital stay, morbidity and mortality (Bion et al., 2012). The detrimental impacts of CRBSIs highlight the importance of implementing infection prevention measures. This dissertation aims to evaluate the effectiveness of antibioticimpregnated, coated or bonded CVCs for the reduction of CRBSIs. The research question: In hospitalised adult patients with central venous catheters, are antibiotic-impregnated, coated or bonded central venous catheters effective in reducing catheter-related blood stream infections? PEO elements: The Population (P) chosen was hospitalised adult patients with CVCs. The Exposure (E) observed was antibiotic-impregnated, coated or bonded CVCs. The Outcome (O) selected was the reduction of CRBSIs. Method: The elements of the PEO questions were identified and used to produce keywords and synonyms. The key terms were used in the literature search, along with Boolean operators and limiters. The search was conducted using the following databases; PubMed, EBSCO and the Northumbria University online library. Inclusion and exclusion criteria were applied to assess the eligibility of the studies. Critical appraisal of the literature was carried out using the CASP tool. Results: A total of eight key studies were identified. These include one randomised control trial (RCT), two meta-analysis and five systematic reviews and meta-analysis. All eight studies found a reduction in the rate of CRBSIs when using antibioticimpregnated, bonded or coated CVCs. Conclusion: It was concluded that antibiotic CVCs reduce the rate of CRBSIs. However, the findings showed that further research needs to be conducted on the cost effectiveness of antibiotic CVCs along with the relationship between antibiotic CVCs and antibiotic resistance. Implications and recommendations: Healthcare professionals need to be educated on the use and benefits of antibiotic CVCs. Infection control guidelines regarding CVCs should be updated. Specialist nurses can deliver educational sessions to healthcare workers and audits can be carried out to ensure adherence to infection prevention measures when handling CVCs.