Archives of Academic Emergency Medicine. 2019; 7 (1): e33 LE T T E R TO ED I TO R The Rate of Catheter-Related Infections using Metal Coated Central Venous Catheters; a Letter to Editor Seyed Hossein Ardehali1, Mona Jahangirian2, Alireza Fatemi3∗ 1. Department of Anesthesiology and Critical Care, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Internal Medicine Department, Shohadaye Tajrish Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Received: April 2019; Accepted: May 2019; Published online: 25 June 2019 Cite this article as: Ardehali S H, Jahangirian M, Fatemi A. The Rate of Catheter-Related Infections using Metal Coated Central Venous Catheters; a Letter to Editor. Arch Acad Emerg Med. 2019; 7(1): e33. Dear editor Blood infections due to intravenous catheters make up about 10% – 15% of hospital infections (1). In 2009, Centers for Disease Control and Prevention (CDC) reported the rate of blood infections related with using central venous catheter in the intensive care unit (ICU) to be 1.65 in 1000 catheters per day (2). Mortality due to infections related to central venous catheters has been reported to be between 12% and 25% in different studies. These infections have increased the dura- tion of hospitalization by 12 days (3, 4). Different approaches have been proposed for reducing these infections, among these approaches using aseptic methods, preventive antibiotics, disposable tools, and training the staff can be pointed out (5-7). Among the methods considered in this regard is using catheters coated with antiseptic agents, antibiotics, and metals such as silver and platinum (8). Some studies have suggested using these methods for reducing the mentioned infections and their consequences; however, their use is not currently agreed upon and their effect on re- ducing the infections caused by intravenous tools is still be- ing studied. Recently, these tools have become available in Iran and since there is limited or insufficient experience working with them, the authors of the present letter designed a comparative study aiming to evaluate the role of central venous catheters coated with metals such as gold, silver, and palladium in the rate of catheter-related infections. In this study, 138 patients with the mean age of 60.62 ± 20.13 (17 – 97) years were randomly divided into 2 groups receiving ∗Corresponding Author: Alireza Fatemi; Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel: 00989128949858 Email: dr_fatemi_alireza@yahoo.com either coated or non-coated central venous catheters, and then studied (58% male). The 2 groups were similar regarding sex (p = 0.730) and age (p = 0,409) distribution. 35 patients in the coated group and 42 in the non-coated group developed fever. Finally, 22 (15.9%) cases of infection due to catheter were observed, 8 (36.4%) of which were in the coated group and 14 (63.6%) were in the non-coated group (p = 0.163). In culture, out of the 8 cases in the coated group, 4 cases of Acinetobacter baumannii, 2 cases of klebsiella pneumoniae, 1 case of escherichia coli, and 1 case of staphylococcus au- reus grew. The Gram negative organisms found were all resis- tant to fluoroquinolone family, penicillin, aminoglycosides, third and fourth generation cephalosporins, carbapenems, and colistin. Meanwhile, in culture of the 14 infectious cases found in the non-coated group, 10 cases had acinetobacter baumannii, 1 case had klebsiella pneumoniae, and in 3 cases escherichia coli had grown. All the mentioned organisms were resistant to fluoroquinolone family, penicillin, amino- glycosides, third and fourth generation cephalosporins, car- bapenems, and colistin. In the end, 4 (50%) cases out of the 8 infected cases in the coated catheter group and 8 (57.81%) cases out of the 14 in the non-coated group died (p > 0.05). Based on the results obtained in this study, it seems that despite the decrease in the number of infected cases when metal coated catheters were used, this difference is not sta- tistically significant. The same finding is true when compar- ing the mortality rates of the 2 groups. Therefore, considering the higher cost imposed on the pa- tients for using these tools, more thought should be given to using them. Of course, there is a need for more studies with more accuracy and control groups before the results of the present study can be generalized. This open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0). Downloaded from: http://journals.sbmu.ac.ir/aaem S H. Ardehali et al. 2 1. Appendix 1.1. Acknowledgements The staff members of the intensive care unit of Shohadaye Tajrish Hospital, who kindly cooperated with us in perform- ing this study, are thanked. 1.2. Author’s contribution All authors met the 4 criteria of authorship as recommended by the International Committee of Medical Journal Editors. Authors ORCIDs Seyed Hossein Ardehali: 0000-0002-7662-0551 Alireza Fatemi: 0000-0003-0671-7611 1.3. Conflict of interest The authors declare that there is no conflict of interest re- garding the present study. 1.4. 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