***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 
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    Input: Central venous catheterization represents a significant medical advancement , particularly in the treatment of critical ill . However , there is a high risk of central venous catheters-related infection . A novel antiseptic central venous catheter , made of polyurethane and impregnated with chlorhexidine and silver sulfadiazine , was developed to reduce the risk of catheters-related infection . In this study , we did a r and omized clinical study to determine the efficacy by using antiseptic catheters for the prevention of central venous catheters-related infection in the intensive care units . A total of 204 patients with 235 central venous catheters were studied at the surgical intensive care units at National Taiwan University Hospital between November 1998 and June 1999 . Participants received either a st and ard triple-lumen polyurethane catheter or an antiseptic catheter ( Arrow International , Reading , Pennsylvania , USA ) . Both were indistinguishable from each other . Compared to st and ard polyurethane catheters , antiseptic catheters were less likely to be colonized by microorganisms when they were cultured at the removal ( 8.0 versus 20.0 colonized catheters per 100 catheters ; relative risk 0.34 [ 95 % CI , 0.15 to 0.74 ] ; p<0.01 ) . There was no significant differences between both groups in catheter-related infections ( 0.9 versus 4.9 infections per 100 catheters ; relative risk 0.17 [ 95 % CI , 0.03 to 1.15 ] ; p = 0.07 ) . Gram-positive cocci and fungi were more likely to colonize in the st and ard polyurethane catheters ( p = 0.06 and 0.04 , compared to antiseptic catheters respectively ) . Two of our cases in the control group died directly due to catheter-related c and idemia . No adverse reactions such as hypersensitivity or leukopenia were found in the antiseptic catheter group . Our study showed that central venous catheters with antiseptic coating were safe and had less risk of colonization of bacteria and fungi than st and ard catheters in the critically ill patients Fifty-seven patients developed an episode of catheter-related infection ( CRI ) in the bloodstream during their stay in the intensive care unit ( cases ) and were prospect ively observed to establish the attributable mortality , increase in length of stay , and excess costs . Costs were estimated by multiplying the number of excess days of stay by the reimbursement provided . The outcomes for these cases were compared with those for matched control subjects without CRI . Eight cases were excluded as no control was found . Of the 49 cases , 31 were coagulase-negative staphylococci ( CNS ) . The level of severity was similar for both groups ( APACHE II 15.5 + /- 7 . 2 versus 15.2 + /- 7.3 ) . There were no significant differences ( p > 0 . 20 ) in the mortality observed in the hospital for the cases ( 22.4 % , 95 % confidence interval [ CI ] 0.3 % to 34.9 % ) and the control subjects ( 34.7 % , 95 % CI 21.2 % to 40.1 % ) . Among the survivors , the hospital stay was increased by 19.6 d ( 95 % CI -1.1 ; 40.4 ) . This represents an added cost of 3,124 Euros per episode of CRI among the survivors . In conclusion , our cohort study failed to show a difference in attributable mortality due to CRI in intensive care unit patients . Nevertheless , these infections lead to an increase in hospital stay of approximately 20 d. Each episode of CRI represents an additional cost of more than 3,000 Euros OBJECTIVE To determine the effect of routine intravenous ( IV ) administration set changes on  central venous catheter ( CVC ) colonization and catheter-related bacteremia .  DESIGN Prospect i ve , r and omized , controlled trial . SETTING Eighteen-bed intensive care unit ( ICU ) in a large metropolitan hospital . PARTICIPANTS Two hundred fifty-one patients with 404 chlorhexidine gluconate and silver sulfadiazine-coated multi-lumen CVCs .  INTERVENTIONS CVCs inserted in the ICU and in situ on day 4 were r and omized to have their IV administration sets changed on day 4 ( n = 203 ) or not at all ( n = 201 ) . Use of fluid containers and blood product administration sets was limited to 24 hours . CVCs were removed when not required , infection was suspected , or in place on day 7 . Catheter cultures were performed on removal by blinded laboratory staff . Catheter-related bacteremia was diagnosed by a blinded intensivist using strict definitions . Data were collected regarding catheter duration , site , Acute Physiology and Chronic Health Evaluation ( APACHE ) II score , patient age , diagnosis , hyperglycemia , hypoalbuminemia , immune status , number of fluid containers and IV injections , and administration of propofol , blood , total parenteral nutrition , or lipid infusion . RESULTS There were 10 colonized CVCs in the group receiving a set change and 19 in the group not receiving one . This difference was not statistically significant on Kaplan-Meier survival analysis . There were 3 cases of catheter-related bacteremia per group . Logistic regression found that burns diagnosis and increased ICU stay significantly predicted colonization . CONCLUSION IV administration sets can be used for 7 days in patients with short-term , antiseptic-coated CVCs It has been suggested that central venous catheters impregnated with antiseptics such as chlohexidine and silver-sulfadiazine reduce the risk of catheter-related bacteraemia in intensive care patients . Patients suffering from haematologic malignancy treated by chemotherapy through a central venous catheter are at even greater risk of catheter-related bacteraemia . A prospect i ve double-blind r and omized controlled trial was performed in order to investigate the effectiveness of chlorhexidine and silver-sulfadiazine impregnated catheters ( CH-SS ) in these patients . A total of 680 catheters ( 13,826 catheter days ) were inserted , of which 338 were antiseptic impregnated .  Bloodstream infection was observed in 105 cases with an overall risk of 7.6 per 1000 catheter days . Thirty-two infections ( 30.5 % ) were catheter-related , corresponding to a risk of 2.3 per 1000 catheter days . There was no statistically significant different between the overall rates of bloodstream infection for impregnated and non-impregnated catheters ( 14.5 vs. 16.3 % ) . The incidence of catheter-related infection was also similar in both groups ( 5 vs. 4.4 % ) and there was no difference in the time of the onset of bacteraemia in the two groups . It is concluded that the use of CH-SS catheters in patients with haematologic malignancy reduces neither the overall risk of bloodstream infection , nor the catheter-related infection rate , nor the delay for the occurrence of infection BACKGROUND Little data exist on the burden of device-associated health care-associated infection ( DA-HAI ) in China . This study examined the DA-HAI rate and evaluated its association with device use ( DU ) , length of stay ( LOS ) , and mortality in intensive care units ( ICUs ) in 4 Chinese hospitals . METHODS This was a prospect i ve cohort surveillance study conducted in 7 ICUs in 4 hospitals . We applied International Nosocomial Control Consortium methods and Centers for Disease Control and Prevention (CDC)/National Health and Safety Network ( NHSN ) definitions to determine rates of central line-associated blood stream infection ( CLABSI ) , ventilator-associated pneumonia ( VAP ) , catheter-associated urinary tract infection ( CAUTI ) , DU , crude extra length of hospital stay ( LOS ) , and mortality . RESULTS Between August 2008 and July 2010 , there were a total of 2,631 admissions to the 7 ICUs in the study hospitals . The rate of VAP was 10.46/1,000 mechanical ventilator (MV)-days , the CLABSI rate was 7.66/1,000 central line (CL)-days , and the CAUTI rate was 1.29/1,000 urinary catheter (UC)-days . Pooled DU ratios were 0.43 for MV , 0.71 for CL , and 0.76 for UC . Crude extra LOS was 15 days for patients with CLABSI , 20.5 days for patients with VAP , and 27 days for patients with CAUTI . Crude extra mortality was 14 % for patients with CLABSI , 22 % for patients with VAP , and 43 % for patients with CAUTI . CONCLUSIONS In the study ICUs , VAP and CLABSI rates were higher than CDC/NHSN 's reported data , and LOS and mortality were increased . Compared with the CDC/NHSN and INICC data , the pooled DU ratio for MV was similar , and DU ratios for CL and UC use ratios were slightly higher This study was conducted to evaluate the impact of central venous catheters impregnated with chlorhexidine and silver sulphadiazine on the incidence of colonization and catheter-related bloodstream infection in critically ill patients . One hundred and thirty-three patients requiring central venous catheterization were chosen at r and om to receive either an antiseptic-impregnated triple-lumen catheter ( N=64 ) or a st and ard triple-lumen catheter ( N=69 ) . The mean ( SD ) duration s of catheterization for the antiseptic and st and ard catheters were 11.7 ( 5.8 ) days ( median 10 ; range 3 - 29 ) and 8.9 ( 4.6 ) days ( median 8.0 ; range 3 - 20 ) , respectively ( P=0.006 ) . Fourteen ( 21.9 % ) of the antiseptic catheters and 14 ( 20.3 % ) of the st and ard catheters had been colonized at the time of removal ( P=0.834 ) . Four cases ( 6.3 % ) of catheter-related bloodstream infection were associated with antiseptic catheters and one case ( 1.4 % ) was associated with a st and ard catheter ( P=0.195 ) . The catheter colonization rates were 18.7/1000 catheter-days for the antiseptic catheter group and 22.6/1000 catheter-days for the st and ard catheter group ( P=0.640 ) . The catheter-related bloodstream infection rates were 5.3/1000 catheter-days for the antiseptic catheter group and 1.6/1000 catheter-days for the st and ard catheter group ( P=0.452 ) . In conclusion , our results indicate that the use of antiseptic-impregnated central venous catheters has no effect on the incidence of either catheter colonization or catheter-related bloodstream infection in critically ill patients BACKGROUND Central venous catheter-related infections are a significant medical problem . Improved preventive measures are needed . OBJECTIVE To ascertain 1 ) effectiveness of a second-generation antiseptic-coated catheter in the prevention of microbial colonization and infection ; 2 ) safety and tolerability of this device ; 3 ) microbiology of infected catheters ; and 4 ) propensity for the development of antiseptic resistance . DESIGN Multicenter , r and omized , double-blind , controlled trial . SETTING 9 university-affiliated medical centers . PATIENTS 780 patients in intensive care units who required central venous catheterization . INTERVENTION Patients received either a st and ard catheter or a catheter coated with chlorhexidine and silver sulfadiazine . MEASUREMENTS The authors assessed catheter colonization and catheter-related infection , characterized microbes by molecular typing , and determined their susceptibility to antiseptics . Patient tolerance of the catheter was monitored . RESULTS Patients with the 2 types of catheters had similar demographic features , clinical interventions , laboratory values , and risk factors for infection . Antiseptic catheters were less likely to be colonized at the time of removal compared with control catheters ( 13.3 vs. 24.1 colonized catheters per 1000 catheter-days ; P < 0.01 ) . The center-stratified Cox regression hazard ratio for colonization controlling for sampling design and potentially confounding variables was 0.45 ( 95 % CI , 0.25 to 0.78 ) . The rate of definitive catheter-related bloodstream infection was 1.24 per 1000 catheter-days ( CI , 0.26 to 3.62 per 1000 catheter-days ) for the control group versus 0.42 per 1000 catheter-days ( CI , 0.01 to 2.34 per 1000 catheter-days ) for the antiseptic catheter group ( P = 0.6 ) . Coagulase-negative staphylococci and other gram-positive organisms were the most frequent microbes to colonize catheters . Noninfectious 
    Output:
    
Conclusions Outcomes are superior for catheters impregnated with chlorhexidine/silver sulfadiazine or other antibiotics than for st and ard catheters in preventing CRBSIs and catheter colonization under bundles .
Compared with silver ion-impregnated CVCs , chlorhexidine/silver sulfadiazine antiseptic catheters result ed in fewer cases of microbial colonization of the catheter but did not reduce CRBSIs