• M Antonelli, G De Pascale, V M Ranieri, P Pelaia, R Tufano, O Piazza, A Zangrillo, A Ferrario, A De Gaetano, E Guaglianone, and G Donelli.
• Department of Intensive Care and Anaesthesiology, Università Cattolica del Sacro Cuore, Rome, Italy. m.antonelli@rm.unicatt.it
• J. Hosp. Infect. 2012 Oct 1;82(2):101-7.

BackgroundSilver-impregnated central venous catheters (CVCs) have been proposed as a means for preventing CVC colonization and related bloodstream infections (CRBSIs).AimTo evaluate the efficacy of CVCs impregnated with silver nanoparticles in a large group of critically ill patients.MethodsA prospective, randomized clinical trial was conducted in five intensive care units (ICUs). Three hundred and thirty-eight adult patients requiring CVCs between April 2006 and November 2008 were randomized to receive AgTive silver-nanoparticle-impregnated (SC) or conventional (CC) CVCs. Primary endpoints were CVC colonization (growth of ≥15 colony-forming units from the catheter tip) and incident CRBSIs (meeting the definitions of the Centers for Disease Control and Prevention). Infection-free time (days from initial CVC insertion to initial blood culture positivity) and ICU mortality rates were measured as secondary endpoints.FindingsThe SC group (N = 135) and CC group (N = 137) were similar in terms of clinical and laboratory parameters at baseline, reasons for ICU admission, complications during CVC insertion, and total time with CVC (mean ± standard deviation; SC 13 ± 24 vs CC 15 ± 37 days). No significant intergroup differences were found in CVC colonization rates (SC 32.6% vs CC 30%; P = 0.7), CRBSI incidence rates (3.36 infections per 1000 catheter-days in both groups), infection-free times (SC 13 ± 34 vs CC 12 ± 12 days; P = 0.85) or ICU mortality (SC 46% vs CC 43%; P = 0.7).ConclusionIn critically ill patients, use of AgTive(®) silver-nanoparticle-impregnated CVCs had no significant effect on CVC colonization, CRBSI incidence or ICU mortality. These CVCs cannot be recommended as an adjunctive tool for control of CRBSIs.Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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