***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: OBJECTIVE To test the efficacy of the ARROWgard ( Arrow International Inc , Reading , Pa ) central venous catheter ( CVC ) coated with silver sulfadiazine and chlorhexidine ( A-CVC ) in the prevention of CVC-related infections . DESIGN Prospect i ve , r and omized trial . SETTING A tertiary care medical center . PATIENTS AND INTERVENTION Two hundred eighty-two patients who required CVC placement were evaluated in this study . Patients were prospect ively r and omized to receive either a st and ard CVC ( S-CVC ) or the A-CVC . Only fresh-stick double- and triple-lumen catheters were studied . MAIN OUTCOME MEASURES Patients were evaluated for catheter site inflammation , catheter site colonization , local catheter-related infection , and catheter-related septicemia . RESULTS The 2 groups were matched for age , percentage in the intensive care unit , percentage receiving total parenteral nutrition , percentage with triple-lumen catheters , and duration of catheterization . Rates of catheter site inflammation in the 2 groups were similar ( 12 % vs 10 % , S-CVC group and A-CVC group , respectively ) . The A-CVC was associated with a significantly decreased catheter site colonization rate ( 49 % vs 28 % ; 43 % reduction ; P<.001 ) and local catheter-related infection rate ( 22.4 % vs 5.8 % ; 74 % reduction ; P<.001 ) . Rates of catheter-related septicemia were reduced by 41 % in the A-CVC group ( 6.4 % vs 3.8 % , S-CVC group and A-CVC group , respectively ) , but this was not statistically significant . CONCLUSIONS Despite a marked decrease in catheter site colonization and catheter-related infection rates , the A-CVC did not significantly reduce the incidence of catheter-related septicemia . This may be due to a greater pathogenic dependence on catheter hub contamination rather than catheter site colonization or local catheter-related infection , or the relatively short ( 5.2 days ) duration of catheterization in this study 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 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 Introduction Only a minimum is known about clinical effect of antimicrobial-coated central venous catheters ( CVC ) in stem cell transplantation setting s , where CVC-related infections impose major threat to severely immunocompromised patients . Material s and methods In this prospect i ve , non-sponsored and nonr and omized study , there were 49 uncoated multi-lumen and non-tunneled CVCs  and 58  antimicrobial chlorhexidine/silver sulfadiazine-coated CVCs inserted in allogeneic stem cell transplanted patients to facilitate treatment during conditioning and pre-engraftment phase ( < 30days after transplantation ) . Results and discussion No significant differences were found between the two groups with respect to gender , age , intensity of pretransplant chemotherapy conditioning , duration of leucopenia , number of days with inserted CVC , number of CVC occlusive dressing changes performed per patient , and number of non-CVC-related infections . In the antimicrobial coated CVC group , there were observed less median days with fever [ 2 ( 0–18 ) vs. 4 ( 0–16 ) , p = 0,17 ] , fever incidence ( 67 % vs. 77.5 % , p = 0.28 ) , and less days with fever per 1,000 catheter-days ( 108 vs. 147 , p = 0.001 ) , less patients with positive CVC blood cultures ( 36 % vs. 45 % , p = 0.05 ) , repeatedly positive CVC blood cultures ( 8.6 % vs. 26 % , p = 0,018 ) , less positive CVC blood cultures per 1,000 catheter-days ( 14 vs. 29 , p = 0.005 ) , and less positive CVC tip cultures ( 17.3 % vs. 34.6 % , p = 0.065 ) observed . Conclusion Lower number of patients with fever , days with fever , and lower number of patients with positive and repeatedly positive CVC blood cultures indicates less intensive antibiotic and antipyretic treatment probably needed in neutropenic allo-transplanted patients with indwelling antimicrobial-coated CVCs . Real impact on antibiotic consumption should be verified in large r and omized study OBJECTIVE To evaluate the cost-effectiveness of the antiseptic-impregnated catheter compared with conventional catheters in preventing catheter- related blood stream infections ( CR-BSI ) . DESIGN Cost-effectiveness analysis ; clinical trial , experimental , r and omized , controlled , prospect i ve , open label . Patients and methods . A 172 patient cohort , under 1-year-old or less than 10 kg , postoperative cardiovascular children with central venous catheters ( CVC ) admitted to Cardiac Intensive Care Unit ( UCI 35 ) at Hospital Nacional de Pediatría " Prof. Dr. Juan P. Garrahan " , since September 2005 to December 2007 . Demographic and CVC data were retrieved to compare : age , gender , weight , diagnosis , surgery , CVC days , costs and complications . Intervention . CVC Arrow , double-lumen , > 48 h of duration ; intervention group : antiseptic-impregnated CVC vs. control group : CVC without antiseptics ( conventional ) . RESULTS The incidence of CR-IE ( CR-Infected Events : colonization , local infection and /or CRBSI ; combined end point ) was 27 % for antiseptic- impregnated CVC vs. 31 % for conventional catheters ( p= 0.6 ) with similar accumulated incidence of CR- BSI : 2.8 vs. 3.3 per 1000 dayscatheter . We found no differences between groups , except in weight : median 4.0 kg ( r 2 - 17 ) vs. 4.7 kg ( r 2 - 9 ) p= 0.0002 and age , median 2 months ( r 1- 48 ) vs. 5 months ( r 1- 24 ) p= 0.0019 in antiseptic-impregnated CVC group . These differences , though statistically significant were clinical ly non relevant . Median cost per patient during intensive care stay in the conventional CVC group was $ 3.417 ( 359 - 9.453 ) and in the antiseptic-impregnated-CVC group was $ 4.962 ( 239 - 24.532 ) , p= 0.10 . CONCLUSIONS 
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However , catheter impregnation made no significant difference to the rates of clinical ly diagnosed sepsis ( RR 1.0 , 95 % CI 0.88 to 1.13 ; moderate- quality evidence , down grade d due to a suspicion of publication bias ) , all-cause mortality ( RR 0.92 , 95 % CI 0.80 to 1.07 ; high- quality evidence ) and catheter-related local infections ( RR 0.84 , 95 % CI 0.66 to 1.07 ; 2688 catheters , moderate quality evidence , down grade d due to wide 95 % CI).In our subgroup analyses , we found that the magnitudes of benefits for impregnated CVCs varied between studies that enrolled different types of participants .
However , there was no such variation for the outcome of CRBSI .
The magnitude of the effects was also not affected by the participants ' baseline risks .
This review confirms the effectiveness of antimicrobial CVCs in reducing rates of CRBSI and catheter colonization .
However , the magnitude of benefits regarding catheter colonization varied according to setting , with significant benefits only in studies conducted in ICUs .
A comparatively smaller body of evidence suggests that antimicrobial CVCs do not appear to reduce clinical ly diagnosed sepsis or mortality significantly .