BACKGROUND: Dialysis-related infections are the commonest cause of catheter loss and transfer to hemodialysis. Surface modifications of the catheter that reduce infections are of major importance. OBJECTIVE: The efficacy of silver-ion treated catheters in reducing dialysis-related infections was tested. METHODS: The study design was a prospective, randomized controlled trial. Patients were implanted with either a silver-treated study catheter or a control catheter. Prospective collection of data included infectious complications and catheter survival. RESULTS: The subject groups were comprised of 67 silver-treated catheters and 72 control catheters. Demographic characteristics of the study and control groups were equal. Exit-site infection rates for the study group and control group (0.52 and 0.45 episodes/patient-year of dialysis respectively) were not different by Poisson regression analysis (p > 0.4). Peritonitis rates were identical for the two groups (0.37 episodes/patient-year) and were not different by Poisson analysis (p > 0.9). Antibiotic-free intervals between infections for the study and control groups were not significantly different for exit-site infections (p = 0.58), peritonitis (p = 0.44), or both infections combined (p = 0.47). Actuarial analyses showed no differences between the groups in the probability of remaining free of exit-site infection (p > 0.2) or peritonitis (p > 0.7). Similarly, catheter survival was not significantly different between the groups (p > 0.6). CONCLUSION: Surface modification of catheters with ion beam implantation of silver produced no clinical effect with respect to reducing dialysis-related infections.
RCT Entities:
BACKGROUND: Dialysis-related infections are the commonest cause of catheter loss and transfer to hemodialysis. Surface modifications of the catheter that reduce infections are of major importance. OBJECTIVE: The efficacy of silver-ion treated catheters in reducing dialysis-related infections was tested. METHODS: The study design was a prospective, randomized controlled trial. Patients were implanted with either a silver-treated study catheter or a control catheter. Prospective collection of data included infectious complications and catheter survival. RESULTS: The subject groups were comprised of 67 silver-treated catheters and 72 control catheters. Demographic characteristics of the study and control groups were equal. Exit-site infection rates for the study group and control group (0.52 and 0.45 episodes/patient-year of dialysis respectively) were not different by Poisson regression analysis (p > 0.4). Peritonitis rates were identical for the two groups (0.37 episodes/patient-year) and were not different by Poisson analysis (p > 0.9). Antibiotic-free intervals between infections for the study and control groups were not significantly different for exit-site infections (p = 0.58), peritonitis (p = 0.44), or both infections combined (p = 0.47). Actuarial analyses showed no differences between the groups in the probability of remaining free of exit-site infection (p > 0.2) or peritonitis (p > 0.7). Similarly, catheter survival was not significantly different between the groups (p > 0.6). CONCLUSION: Surface modification of catheters with ion beam implantation of silver produced no clinical effect with respect to reducing dialysis-related infections.
Authors: Htay Htay; David W Johnson; Jonathan C Craig; Francesco Paolo Schena; Giovanni Fm Strippoli; Allison Tong; Yeoungjee Cho Journal: Cochrane Database Syst Rev Date: 2019-05-31
Authors: Sabina Rebe Raz; Maria Leontaridou; Maria G E G Bremer; Ruud Peters; Stefan Weigel Journal: Anal Bioanal Chem Date: 2012-03-27 Impact factor: 4.142
Authors: Denise Campbell; David W Mudge; Jonathan C Craig; David W Johnson; Allison Tong; Giovanni Fm Strippoli Journal: Cochrane Database Syst Rev Date: 2017-04-08
Authors: Rohan A Shirwaiker; Meghan E Samberg; Paul H Cohen; Richard A Wysk; Nancy A Monteiro-Riviere Journal: Wiley Interdiscip Rev Nanomed Nanobiotechnol Date: 2013-01-17