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To the Editor: In their meta-analysis, Dr Veenstra and colleagues¹ concluded that catheters coated with a combination of chlorhexidine and silver sulfadiazine (CSS) appear to be effective in reducing the incidence of both catheter colonization and catheter-related bloodstream infection in patients at high risk for catheter-related infection. However, the individual trials do not provide strong evidence of efficacy overall. The largest clinical trial, performed by Logghe et al,² was excluded because of the definition of catheter-related bacteremia. In this study, catheter-related bacteremia was defined as blood from the catheter containing at least 5 times as many colony forming units as peripheral blood. When the central venous catheter cannot be removed, the method appears adequate for the diagnosis of catheter-related bacteremia and has been reported to have 77.8% sensitivity, 100% specificity, and a global accuracy of 91.7%.³ In this study, a total of 680 catheters were inserted in patients with hematologic . . . [Full Text of this Article]

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