ISSN: 1859 - 2872
Effectiveness of minocycline/rifampin-impregnated central venous catheters in the prevention of central venous catheter-associated bloodstream infections in the neuro-intensive care unit
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Background: Central venous catheters (CVCs) are widely used in neuro-intensive care unit (Neuro-ICU), but carry a high risk of central venous catheter-associated bloodstream infections (CLABSI). Minocycline/rifampicin-impregnated CVCs (M/R-CVCs) can reduce this risk, but limited data are available specifically for Neuro-ICU. Objective: To evaluate the incidence and microbiological profiles of CLABSI in Neuro-ICU patients with M/R-CVCs. Subject and method: A prospective study was conducted among critically ill adults with M/R-CVCs. Catheter segments and blood were cultured after removal. CLABSI was defined according to CDC/NHSN 2024 criteria. Result: Seventy adult patients were included in the study. The mean age of patients was 57.1 years (57.07 ± 17.37), and 46 (65.7%) were male. Most patients had ≥2 comorbidities (60/70, 85.7%), and catheters remained in place for >7 days (55/70, 78.6%). Catheter colonization occurred in 11 (15.7%) cases, mainly at the insertion site. The observation period was characterized by an absence of CLABSI. The colonizing organisms were primarily Gram-negative bacilli, while catheter and blood culture results remained uncorrelated. Conclusion: The use of M/R-CVC was associated with a low colonization rate and the absence of CLABSI, which supports its consideration for infection prevention in high-risk patients in the Neuro-ICU.
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1. Raad I, Darouiche R, Dupuis J et al (1997) Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections: a randomized, double-blind trial. Ann Intern Med 127(4): 267-274. doi:10.7326/0003-4819-127-4-199708150-00002
2. Maki DG, Stolz SM, Wheeler S, Mermel LA (1997) Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med 127(4): 257-266. doi:10.7326/0003-4819-127-4-199708150-00001
3. Raad I, Darouiche R, Hachem R, Mansouri M, Bodey GP (1996) The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J Infect Dis 173(2): 418-424. doi:10.1093/infdis/173.2.418
4. Pemberton LB, Ross V, Cuddy P et al (1996) No difference in catheter sepsis between standard and antiseptic central venous catheters: A prospective randomized trial. Arch Surg 131(9): 986-989. doi:10.1001/archsurg.1996.01430210084018
5. Tennenberg SD, Lieser MJ, McCurdy B et al (1997) A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections. Arch Surg. 132(12): 1348-1351. doi:10.1001/archsurg.1997.01430360094017
6. Mermel LA, Allon M, Bouza E et al (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 49(1): 1-45. doi:10.1086/599376
7. Centers for Disease Control and Prevention (CDC). National Healthcare Safety Network (NHSN) Patient Safety Component Manual: Bloodstream Infection (BSI) Event. 2024. Accessed June 17, 2025. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf
8. Rodríguez-Aguirregabiria A, Ayllon M, Gandarias Z, et al (2022) Predictors of central line-associated bloodstream infections in ICU patients. PLoS One. 17(8): 0265098. doi:10.1371/journal.pone.0265098
9. Rameshkumar R, Natarajan P, Bhanupriya B et al (2021) Study of central line associated blood stream infection in ICU patients. Int J Adv Med 8(4):607-611.
10. Lunnemar P, Taxbro K, Hammarskjöld F. An analysis of central venous catheter-related bloodstream infections in patients treated in a Swedish Covid-19 intensive care unit. SAGE Open Med. 2024;12:20503121241233213.
11. Maqbool S, Sharma R (2023) A two-year surveillance of central line-associated bloodstream infections in the trauma ICU of a tertiary care hospital in India. Cureus 15(10): 45325. doi:10.7759/cureus.45325
12. Wylie MC, Graham DA, Potter-Bynoe G et al (2010) Risk factors for central line-associated bloodstream infection in pediatric intensive care units. Infect Control Hosp Epidemiol 31(10): 1049-1056. doi: 10.1086/656596
13. Rajandra A, Yunos NM, Teo CH et al (2025) Incidence, compliance, and risk factors associated with central line-associated bloodstream infection (CLABSI) in intensive care unit (ICU) patients: A multicenter study in an upper middle-income country. Antibiotics. 14(3): 271. doi:10.3390/antibiotics14030271
14. Marschall J, Mermel LA, Fakih M et al (2014) Clinical impacts and risk factors for central line-associated bloodstream infection: A systematic review. Infect Control Hosp Epidemiol 35(2):184-194. doi:10.1086/674013.
15. Alomari S, Yahya M, Alabadlah N et al (2025) Central line-associated bloodstream infections (CLABSI) in critical care: understanding incidence, and risk factors in Palestine. BMC Infect Dis 25(1):463. doi:10.1186/s12879-025-10855-0
16. Marik PE, Flemmer M, Harrison W (2012) The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review and meta-analysis. Crit Care Med. 40(8): 2479-2485. doi:10.1097/CCM.0b013e318255d9bc
17. O'Grady NP, Alexander M, Burns LA et al (2011) Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 52(9): 1087-1099. doi:10.1093/cid/cir138
18. Parienti JJ, Mongardon N, Mégarbane B et al (2015) Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 373(13): 1220-1229. doi:10.1056/NEJMoa1500964
19. Bayoumi MAA, van Rens MFPT, Chandra P et al (2022) Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study. Front Pediatr 10: 1012800. doi:10.3389/fped.2022.1012800
20. Buetti N, Marschall J, Drees M et al (2022) Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol 43(5): 553-569. doi:10.1017/ice.2022.87
21. Jia CM, Feng SY, Li Y et al (2019) Procalcitonin for predicting catheter-associated bloodstream infection: A meta-analysis. Medicine (Baltimore). 98(52): 18546. doi:10.1097/MD.0000000000018546
22. Trautner BW, Darouiche RO (2024) Catheter-associated infections: pathogenesis affects prevention. Arch Intern Med. 2004;164(8):842-850. doi:10.1001/archinte.164.8.842
23. Eggimann P, Pagani JL, Dupuis-Lozeron E et al (2019) Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years. Intensive Care Med 45(6): 823-833. doi: 10.1007/s00134-019-05617-x
24. Zeng C, Wu A, Li L, Jia H (2021) Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China. BMC Infect Dis 21(1): 1208. doi: 10.1186/s12879-021-06871-5.
25. Lorente L, Henry C, Martín MM, Jiménez A, Mora ML (2005) Central venous catheter-related infection in a prospective and observational study of 2,595 catheters. Crit Care 9(6): 631-635. doi:10.1186/cc3824
26. Hanna H, Benjamin RS, Chatzinikolaou I et al (2004) Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: A prospective randomized clinical trial. J Clin Oncol 22(15): 3163-3171. doi:10.1200/JCO.2004.04.124
27. Puig-Asensio M, Padilla B, Garnacho-Montero J et al (2014) Epidemiology and predictive factors for early and late mortality in Candida bloodstream infections: a population-based surveillance in Spain. Clin Microbiol Infect 20(4): 245-254. doi:10.1111/1469-0691.12380.
2. Maki DG, Stolz SM, Wheeler S, Mermel LA (1997) Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med 127(4): 257-266. doi:10.7326/0003-4819-127-4-199708150-00001
3. Raad I, Darouiche R, Hachem R, Mansouri M, Bodey GP (1996) The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J Infect Dis 173(2): 418-424. doi:10.1093/infdis/173.2.418
4. Pemberton LB, Ross V, Cuddy P et al (1996) No difference in catheter sepsis between standard and antiseptic central venous catheters: A prospective randomized trial. Arch Surg 131(9): 986-989. doi:10.1001/archsurg.1996.01430210084018
5. Tennenberg SD, Lieser MJ, McCurdy B et al (1997) A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections. Arch Surg. 132(12): 1348-1351. doi:10.1001/archsurg.1997.01430360094017
6. Mermel LA, Allon M, Bouza E et al (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 49(1): 1-45. doi:10.1086/599376
7. Centers for Disease Control and Prevention (CDC). National Healthcare Safety Network (NHSN) Patient Safety Component Manual: Bloodstream Infection (BSI) Event. 2024. Accessed June 17, 2025. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf
8. Rodríguez-Aguirregabiria A, Ayllon M, Gandarias Z, et al (2022) Predictors of central line-associated bloodstream infections in ICU patients. PLoS One. 17(8): 0265098. doi:10.1371/journal.pone.0265098
9. Rameshkumar R, Natarajan P, Bhanupriya B et al (2021) Study of central line associated blood stream infection in ICU patients. Int J Adv Med 8(4):607-611.
10. Lunnemar P, Taxbro K, Hammarskjöld F. An analysis of central venous catheter-related bloodstream infections in patients treated in a Swedish Covid-19 intensive care unit. SAGE Open Med. 2024;12:20503121241233213.
11. Maqbool S, Sharma R (2023) A two-year surveillance of central line-associated bloodstream infections in the trauma ICU of a tertiary care hospital in India. Cureus 15(10): 45325. doi:10.7759/cureus.45325
12. Wylie MC, Graham DA, Potter-Bynoe G et al (2010) Risk factors for central line-associated bloodstream infection in pediatric intensive care units. Infect Control Hosp Epidemiol 31(10): 1049-1056. doi: 10.1086/656596
13. Rajandra A, Yunos NM, Teo CH et al (2025) Incidence, compliance, and risk factors associated with central line-associated bloodstream infection (CLABSI) in intensive care unit (ICU) patients: A multicenter study in an upper middle-income country. Antibiotics. 14(3): 271. doi:10.3390/antibiotics14030271
14. Marschall J, Mermel LA, Fakih M et al (2014) Clinical impacts and risk factors for central line-associated bloodstream infection: A systematic review. Infect Control Hosp Epidemiol 35(2):184-194. doi:10.1086/674013.
15. Alomari S, Yahya M, Alabadlah N et al (2025) Central line-associated bloodstream infections (CLABSI) in critical care: understanding incidence, and risk factors in Palestine. BMC Infect Dis 25(1):463. doi:10.1186/s12879-025-10855-0
16. Marik PE, Flemmer M, Harrison W (2012) The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review and meta-analysis. Crit Care Med. 40(8): 2479-2485. doi:10.1097/CCM.0b013e318255d9bc
17. O'Grady NP, Alexander M, Burns LA et al (2011) Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 52(9): 1087-1099. doi:10.1093/cid/cir138
18. Parienti JJ, Mongardon N, Mégarbane B et al (2015) Intravascular complications of central venous catheterization by insertion site. N Engl J Med. 373(13): 1220-1229. doi:10.1056/NEJMoa1500964
19. Bayoumi MAA, van Rens MFPT, Chandra P et al (2022) Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study. Front Pediatr 10: 1012800. doi:10.3389/fped.2022.1012800
20. Buetti N, Marschall J, Drees M et al (2022) Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol 43(5): 553-569. doi:10.1017/ice.2022.87
21. Jia CM, Feng SY, Li Y et al (2019) Procalcitonin for predicting catheter-associated bloodstream infection: A meta-analysis. Medicine (Baltimore). 98(52): 18546. doi:10.1097/MD.0000000000018546
22. Trautner BW, Darouiche RO (2024) Catheter-associated infections: pathogenesis affects prevention. Arch Intern Med. 2004;164(8):842-850. doi:10.1001/archinte.164.8.842
23. Eggimann P, Pagani JL, Dupuis-Lozeron E et al (2019) Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years. Intensive Care Med 45(6): 823-833. doi: 10.1007/s00134-019-05617-x
24. Zeng C, Wu A, Li L, Jia H (2021) Multi-center prospective study on central line-associated bloodstream infections in 79 ICUs of China. BMC Infect Dis 21(1): 1208. doi: 10.1186/s12879-021-06871-5.
25. Lorente L, Henry C, Martín MM, Jiménez A, Mora ML (2005) Central venous catheter-related infection in a prospective and observational study of 2,595 catheters. Crit Care 9(6): 631-635. doi:10.1186/cc3824
26. Hanna H, Benjamin RS, Chatzinikolaou I et al (2004) Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: A prospective randomized clinical trial. J Clin Oncol 22(15): 3163-3171. doi:10.1200/JCO.2004.04.124
27. Puig-Asensio M, Padilla B, Garnacho-Montero J et al (2014) Epidemiology and predictive factors for early and late mortality in Candida bloodstream infections: a population-based surveillance in Spain. Clin Microbiol Infect 20(4): 245-254. doi:10.1111/1469-0691.12380.
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ThanhN. C., VinhN. T., LuanN. V., TuT. D., BichG. T. N., LinhN. D., ThanhT. T., My N. H., & ToanL. D. (2025). Effectiveness of minocycline/rifampin-impregnated central venous catheters in the prevention of central venous catheter-associated bloodstream infections in the neuro-intensive care unit. Journal of 108 - Clinical Medicine and Phamarcy, 20(TA). https://doi.org/10.52389/ydls.v20iTA.2901