Abstract:
Background: Central line-associated bloodstream infections (CLABSIs) cause preventable harm. We evaluated whether Chlorhexidine/Silver Sulfadiazine (CH/SSD)-impregnated CVCs reduce the CLABSI hazard compared with plain CVCs using time-to-event methodology.
Methods: A prospective cohort study was conducted in 6 hospitals in India, Malaysia, Papua New Guinea, and Turkey from 03/01/2023-10/31/2025. We included 1,294 plain-CVC patients and 456 CH/SSD-CVC patients. The primary endpoint was time to first CLABSI, estimated by Kaplan-Meier modeled with Cox proportional hazards regression. A prespecified landmark analysis assessed early risk at days 0-5.
Results: Within 30 days, 51 CLABSIs occurred in the plain-CVC group and 12 in the CH/SSD group. Kaplan-Meier cumulative incidence at 30 CVC-days showed statistically significant separation (log-rank X2= 5.309; p=0.021). In the primary Cox proportional hazards model, CH/SSD-CVCs were associated with a significantly lower hazard of CLABSI than plain-CVCs (hazard ratio=0.297; 95%CI= 0.134-0.658; p=0.003). In the prespecified early 0-5-day period, 13 CLABSIs occurred in the plain-CVC group and 0 in the CH/SSD-CVC group (log-rank X2=4.923; p=0.026). ICU mortality was higher in the plain-CVC group (28.3% vs. 18.4%; p<0.001).
Conclusions: CH/SSD-CVCs were associated with a significant reduction in the CLABSI hazard, supporting further study of their use as tools to prevent CLABSI.
Reference:Rosenthal VD, Jin Z, Yin R, Basri MNM, Hoong LY, Mohamad F, Kharbanda M, Nag B, Bhakta A, Todi SK, Bhattacharyya M, Guclu E, Gazioglu EO, Ogutlu A, Karabay O, Gupta S, Tumu N, Perez V. Prospective Multicenter Multinational Cohort Study: Time-to-central line-associated bloodstream infection with Plain vs Chlorhexidine/Silver Sulfadiazine Impregnated Central Venous Catheters. Am J Infect Control. 2026 Jul 11:S0196-6553(26)00586-9. doi: 10.1016/j.ajic.2026.07.005. Epub ahead of print. PMID: 42435938.