Background: Central venous catheters (CVCs) are widely used in critically ill patients, including cancer patients, but are associated with complications such as catheter-related bloodstream infections (CRBSIs). This study evaluates the effectiveness of polyhexamethylene biguanide (PHMB)-coated CVCs in reducing catheter-tip bacterial colonization in cancer patients undergoing abdominal surgery.

Methods: A prospective, randomized, monocentric clinical trial was conducted at Peking University Cancer Hospital from March 2017 to April 2019. Surgical cancer patients requiring CVCs were randomized into two groups: a PHMB-coated CVC group (Certofix® protect) and a standard CVC group (Certofix®). The primary outcome was catheter tip bacterial colonization, and the secondary outcomes included catheter retention time and hospital length of stay.

Results: A total of 1,185 patients were included in the analysis. The incidence of catheter tip bacterial colonization was 2.5% in the PHMB-coated group and 4.2% in the standard CVC group (p = 0.10). Hospital length of stay was significantly shorter in the PHMB-coated group (p < 0.001). Subgroup analysis showed reduced bacterial colonization in male patients in the PHMB-coated group (p = 0.04).

Conclusion: Polyhexamethylene biguanide-coated CVCs did not significantly reduce catheter tip bacterial colonization in the overall population but showed a beneficial effect in male cancer patients undergoing abdominal surgery. In clinical practice, it is necessary to consider various factors when selecting the type of catheter.

Clinical trial registration: No. chiCTR-IPR-16010027.

Dong J, Yang Y, Li Q, Xu JX, Shen YF, Wang HZ. Effect of polyhexamethylene biguanide-coated central venous catheters on bacterial colonization in cancer patients undergoing abdominal surgery: a randomized controlled trial. Front Med (Lausanne). 2025 Feb 19;12:1507352. doi: 10.3389/fmed.2025.1507352. PMID: 40046915; PMCID: PMC11879799.