Abstract
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.