***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Recent developments in dressings for intravenous access sites include a transparent dressing which does not retain moisture . This article describes a r and omised controlled trial to compare the new dressing with a st and ard dressing . There was no difference in sepsis rates between the two groups , and both methods had advantages and disadvantages . The authors suggest that cost may be a factor in choice of dressing Objective : To evaluate silver-impregnated ( Oligon ) central venous catheters and chlorhexidine – gluconate-impregnated sponges for reducing catheter-related colonization and infection , nonbacteremic or bacteremic . Design : Multicenter , prospect i ve , r and omized , controlled study . Setting : Five general intensive care units in Greece . Patients : Intensive care unit patients requiring a multilumen central venous catheter between June 2006 and May 2008 . Interventions : Patients were r and omly assigned to receive a st and ard catheter ( st and ard group ) , a st and ard catheter plus chlorhexidine – gluconate-impregnated sponge ( chlorhexidine – gluconate-impregnated sponge group ) , or an Oligon catheter ( Oligon group ) . Catheter colonization was defined as a positive quantitative tip culture ( ≥103 colony-forming units/mL ) , catheter-related infection was defined by the previous criterion plus clinical evidence of sepsis , and bacteremia catheter-related infection as catheter-related infection plus a positive peripheral blood culture with the same micro-organism as in the catheter tip . Measurements and Main Results : Data were obtained from 465 patients , 156 in the st and ard-group , 150 in the chlorhexidine – gluconate-impregnated sponge group , and 159 in the Oligon-group . Colonization occurred in 24 ( 15.4 % ) st and ard catheters , 21 ( 14 % ) in the chlorhexidine – gluconate-impregnated sponge group , and 25 ( 15.7 % ) in the Oligon catheters ( p = .35 ) ( 20.9 , 19.9 , 21.8/1000 catheter-days , respectively ) . Catheter-related infections were recorded in nine ( 5.8 % ) st and ard catheters , six ( 4 % ) in the chlorhexidine – gluconate-impregnated sponge group , and seven ( 4.4 % ) in the Oligon catheters ( p = .58 ) ( 7.8/1,000 , 5.7/1,000 , 6.1/1,000 catheter-days , respectively ) . No difference was observed between the chlorhexidine– gluconate-impregnated sponge group and the st and ard group regarding catheter colonization ( hazard ratio 1.21 ; 95 % confidence interval 0.56–2.61 ; p = .64 ) and catheter-related infections ( hazard ratio 0.65 ; 95 % confidence interval 0.23–1.85 ; p = .42 ) . The Oligon catheter did not reduce colonization or catheter-related infections when compared with the st and ard catheter ( colonization : hazard ratio 1.0 ; 95 % confidence interval 0.46–2.21 ; p = .98 ; catheter-related infection : hazard ratio 0.72 ; 95 % confidence interval 0.27–1.95 ; p = .52 ) . Seven patients ( 1.5 % , 2.09/1,000 catheter-days ) presented bacteremic catheter-related infections . Central venous catheters inserted either in the internal jugular or the femoral vein had greater risk to be colonized than catheters inserted in the subclavian vein ( internal jugular vs. subclavian : hazard ratio 3.29 ; 95 % confidence interval 1.26–8.61 ; p = .01 ; femoral vs. subclavian : hazard ratio 3.36 ; 95 % confidence interval 1.17–9.65 ; p = .02 ) . Acinetobacter baumannii was the predominant pathogen ( 37.1 % episodes of colonization , 36.4 % catheter-related infections , 57.1 % bacteremic catheter-related infections ) . Conclusion : For short-term ( median duration 7 days ) central venous catheters in intensive care units with high prevalence of multiresistant Gram-negative bacteria , chlorhexidine-impregnated sponges and Oligon catheters as single preventive measures did not reduce catheter colonization or catheter-related infections . As a result of the limited amount of events , no conclusion could be reached regarding bacteremic catheter-related infections . The femoral site was the most frequently colonized insertion site in all types of catheters Objective : Our aim was to evaluate the safety of a silver – alginate-containing dressing to reduce peripherally inserted central catheter ( PICC ) infections  in neonatal intensive care unit ( NICU ) patients . Study Design : Patients were r and omized 3:1 to receive a patch containing silver , alginate and maltodextrin or st and ard of care . Patches were placed under the regular transparent retention dressing at the PICC exit site at insertion and were replaced with every dressing change at least every 2 weeks until PICC discontinuation . All study infants were monitored for adverse skin reactions . Result : A total of 100 infants were followed up for 1922 person-days , including 75 subjects with 89 PICCs who received the patch . The  median birth weight ( 1330 g ) and median gestational age ( 30 weeks ) was lower in the patch group when compared with the controls ( P=0.001 and 0.005 , respectively ) . Study patients received the patch with their PICC at a median age of 5 days ; the patch stayed in place for a median of 13 days . We noted no adverse skin reactions and found no evidence that the patch alters the microbiology of PICC-associated infections . Conclusion : This pilot trial suggests that silver – alginate-coated dressings are skin safe and their inclusion in future trials aim ed at reduction of PICC-associated bloodstream infections in the NICU should be considered The objective of this study was to assess the risk of bacteremia , estimate the cost and evaluate the quality of life by using a transparent dressing ( TD ) versus ( vs ) a dry gauze ( DG ) on the exit site of long term central I.V. catheters ( LTCC ) of hemodialysis patients . This 6-months preliminary study was conducted on 58 patients ( pts ) r and omized to receive DG replaced 3 times/week ( 29 pts ) or TD replaced every 7 days ( 29 pts ) .  Data on patients , conditions of the exit site , local infection , bacteremia , quality of life and cost related to each type of dressing were collected . Two pts in the DG group experienced bacteremia related to their LTCC vs 1 pt in the group TD . A total of 7 ( DG ) vs 13 ( TD ) pts experienced skin condition changes at the catheter exit site . Some skin reactions , erythema and pruritus , did occur initially in the group TD and was due in part to insufficient drying time of the skin preparation solution . The estimated individual , weekly costs for using the DG was $ 7.60 vs $ 4.72 Canadian dollars for the TD . The SF-36 ™ scores did not show a significant difference between the 2 groups during the study ( 3.8 ( PCS ) , 6.4 ( MCS ) at study end ) . Although this study was statistically underpowered , it suggests that the incidence of bacteremia was not increased with the use of a TD . Moreover , the use of a TD allowed fewer dressing changes , lowered total treatment costs , with no observed unfavorable impact on the quality of life and without significant local complications of the exit site . Based on the positive results observed in this pilot study , further study is warranted to examine the cost effectiveness of long-term use of TD dressings on dialysis catheter exit sites A prospect i ve r and omized clinical trial has been conducted to compare the clinical performance , with prolonged use , of two film-type transparent dressings used over subclavian and jugular single-lumen venous catheters . ' OpSite ' , a traditional dressing with a moderate moisture vapour permeability was compared with a new dressing of high moisture vapour permeability , ' OpSite IV3000 ' . Information was collected daily to assess the nature and incidence of complications , dressing durability and the ease of application and removal .  One hundred and one patients provided two well-matched population s receiving a total of 153 dressings for a total of 780 catheter-days . No differences between the two dressings were noted with respect to the incidence of complications , such as moisture accumulation or lifting , and dressing durability . The low incidence of catheter-related sepsis ( ' OpSite ' group three episodes and ' OpSite IV3000 ' group one episode ) suggests that transparent dressings do not increase this risk . This clinical study demonstrated the new ' OpSite IV3000 ' to be easier to h and le , leading to better application , improved catheter fixation and easy removal The incidence of catheter-related sepsis associated-with the use of Tegaderm or Opsite IV3000 dressings on 100 critically ill patients with liver disease was studied . All the patients had central venous catheters in situ and they were r and omly assigned to one of the two dressings . In this study the sites of insertion were assessed at each dressing change , together with any fluid under the dressing . No statistically significant difference between the two dressings was found in accumulation of fluid , skin microbial colonization , local infection or systemic infection of patients in our sample . There was no apparent advantage to using the more permeable Opsite IV3000 dressing The objective of the study was to evaluate the effectiveness of chlorhexidine-impregnated sponges for reducing catheter-related infections of central venous catheters inserted for cancer chemotherapy . The method used was a r and omized , prospect i ve , open , controlled clinical study ( three-step group sequential analysis protocol ) . The patients were from two high dependency units at a university hospital undergoing chemotherapy for haematological or oncological malignancies requiring central venous catheters ( CVCs ) expected to remain in place for at least 5 days . Six hundred and one patients with 9,731 catheterization days were studied between January 2004 and January 2006 . Patients admitted for chemotherapy received chlorhexidine and silver sulfadiazine-impregnated triple-lumen CVCs under st and ardized conditions and were r and omized to the groups receiving a chlorhexidine gluconate-impregnated wound dressing or a st and ard sterile dressing . Daily routine included clinical assessment of the insertion site ( swelling , pain , redness ) , temperature , white blood count and C-reactive protein . Catheters remained in place until they were no longer needed or when a CVC-related infection was suspected . Infection was confirmed with blood cultures via the catheter lumina and peripheral blood cultures according to the time-to-positivity method . Six hundred and one patients were included . The groups were comparable with respect to demographic and clinical data . The incidence of CVC-related infections were 11.3 % ( 34 of 301 ) and 6.3 % ( 19 of 300 ) in the control and chlorhexidine-impregnated wound dressing groups , respectively ( p = 0.016 , relative risk 0.54 ; confidence interval 0.31–0.94 ) . Especially , catheter-related infections at internal jugular vein insertions could be reduced ( p = 0.018 ) . No adverse effects related to the intervention were observed . The use of chlorhexidine-impregnated wound dressings significantly reduced the incidence of CVC-related infections in patients receiving chemotherapy Background : The r and omized two-way factorial Dressing Study ( 1,636 patients , 28,931 catheter days ) showed that a chlorhexidine-impregnated sponge decreased the incidence of major catheter-related infections from 1.4‰ to 0.6‰ catheter days , and that scheduled dressing changes every 7 days was not inferior to scheduled changes every 3 days . Here , we assessed the cost benefits of chlorhexidine-impregnated sponge use . Methods : Costs directly related to major catheter-related infections and the costs of chlorhexidine-impregnated sponge and contact dermatitis were calculated prospect ively using microcosting methods during the original study . The added length of stay in the intensive care unit due to major catheter-related infection was estimated using the disability model and assuming a cost of $ 2,118/intensive care unit day . The cost of each strategy was estimated based on all costs and on the probability of major catheter-related infection according to the Dressing Study results . Interventions : None . Results : Median direct cost of major catheter-related infection was $ 792 . Estimated added length of stay due to major catheter-related infection was 11 days ( 95 % confidence interval [ −2 days ; 26 days ] ) . Overall cost of major catheter-related infection was $ 24,090/episode . Each dressing cost $ 9.08 ( 146 observations ) and each chlorhexidine-impre 
    Output:
    
Medication-impregnated dressing products reduce the incidence of catheter-related BSI relative to all other dressing types .
There is some evidence that CGI dressings , relative to SPU dressings , reduce catheter-related BSI for the outcomes of frequency of infection per 1000 patient days , risk of catheter tip colonisation and possibly risk of catheter-related BSI .
A multiple treatment meta- analysis found that sutureless securement devices are likely to be the most effective at reducing catheter-related BSI though this is low quality evidence .