3. Srinivasan A, et al. MMWR 60: 2011; CDC BHSN 2010 Data Summary; Umscheid CA, et al. Infect Control Hosp Epidemiol. 2011; 32:101-114.
Scott RD. Division of Healthcare Quality Promotion, CDC, 2009.

7. CHG/SS
M/R Silver/Platinum/
Carbon (Silver
Iontophoretic; Vantex)
Hydrocath Assure (BD)
Benzalkonium
AMC Thromboshield (Edwards)
Multistar Benzalkonium Heparin
Miconazole/Rifampin
(Vygon)

8. Staphylococcus epidermidis
C/S C
S/C/P M/R
Spangler & Moss, Arrow International

9. Pseudomonas aeruginosa Candida albicans
C/S C/S C
C
S/C/P M/R S/C/P M/R
Spangler & Moss, Arrow International
CH/SS: Poor activity vs Acinetobacter,
Stenotrophomonas, Enterobacter

12. Meta Analysis
Medline search of articles with
“meta-analysis” in title,
2007-2011
 Quality of Reporting of Meta-Analysis (QUORUM) guidelines

14. BSI
Silver Alloy (0.58)
Silver Iontoph (1.98)
Silver Impreg (0.93)
BenzChl (1.0)
Colonization
Silver Alloy (1.21)
Rif/Micon (0.14)
Casey AL, et al. Lancet ID, 2008

15. Ramritu AJIC 2008
Scatter plot of 29 studies (BSI vs. colonization)
Spearman Correlation coefficient:
r = 0.63, r2 = 0.4; P = 0.003

16. Do antimicrobial-coated catheters prevent BSI?
4.2% 0.68
0.47
2.3%
0.29
5.9%
Casey AL, et al. Lancet ID, 2008

18. S. aureus S. epidermidis
1st & 2nd generation CH/SS CVCs 2nd generation CH/SS CVC
2 (58 explanted CVCs)
1
Bassetti, et al AAC 2001 Fey et al, ICAAC, 2000
Duration of activity of M/R appears to be greater than CH/SS

21. Chest, 2004

22. Crit Care Med, 2011

24. Veenstra DL, et al. JAMA 1999
Shorr AF, et al. Chest 2003
Marciante KD, et al. AJIC 2003

25. Conclusions from Cost Effectiveness Studies
Veenstra DL, et al. JAMA 1999
“…the use of chlorhexidine-silver sulfadiazine impregnated catheters
in patients at high risk for infection reduces the incidence of CR-BSI
and death and provides significant saving in costs.”
Shorr AF, et al. Chest 2003
“Utilization of antiseptic and antibiotic-impregnated CVCs represent
an attractive alternative for prevention of CRBSIs and may lead to
significant savings. … the RM CVC performs better financially.”
Marciante KD, et al. AJIC 2003
“CVCs coated with M/R are cost effective for patients catheterized
for at least one week and lead to overall cost savings when patients
are catheterized for 2 weeks or longer.”

26. Health Technology Assessment, 2008

27. Crit Care, 2009

28. (MRSA)
GND
X M/R
* CH/SS
SPC

29. Spectrum of Activity
MRSA P.aer C. albicans C. glabrata
Uncoated
M/R
CH-M/R
CH/SS
Durability vs MRSA
Uncoated
M/R
CH-M/R
CH/SS

30. Kaplan Meier analysis of colonization
Walz, et al. Crit Care Med, 2010