Comparison of common central venous catheters and those antimicrobial-coated in patients with allogeneic stem cell transplantation

Introduction: Central venous catheters (CVC) make long and intensive transplant therapy possible in patients with haematological malignancies. Specialized CVC nursing care is necessary due to risk of various complications including infections. Only a little is known about clinical effect of antimicrobial coated central venous catheters in stem cell transplantation settings, with infections imposing major threat to severely immunocompromised patients. Goal: to compare effect of antimicrobial coated and uncoated CVCs in patients after allogeneic stem cell transplantation. Methods: Prospective, non-randomized study comparing consecutive 49 allotransplanted patients with uncoated multi-lumen non-tunneled CVC and 58 allotransplanted patients with antimicrobial chlorhexidine/silver sulfadiazine coated CVC. Statistics with univariate analyzes were performed on GraphPad Statistica Software. Results: no significant differences were found between the two groups in respect of demography, conditioning regimen, leucopenia, number of days with inserted CVC and number of non-CVC infections. In the antimicrobial coated CVC group, there were observed significantly less days with fever per 1000 catheter-days (108 vs. 147, p=0,001), less positive CVC blood cultures per 1000 catheter-days ( 14 vs. 29, p=0,005), less positive CVC blood cultures (36% vs. 45%, p=0,05) and repeatedly positive CVC blood cultures (8,6% vs. 26%, p=0,01). Conclusion: Antimicrobial coated CVC showed to be effective to reduce fever incidence and CVC blood cultures positivity. Impact on reduced need of antibiotics and antipyretics should be verified in another larger trial or in retrospective analysis.