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Erschienen in:
Biomaterial-Associated Infection: A Perspective from the Clinic Kapitel lesen Erstes Kapitel lesen

2013 | OriginalPaper | Buchkapitel

21. Preventive Strategies in VAP: Focus on Silver-Coated Endotracheal Tubes

verfasst von : Marin Kollef

Erschienen in: Biomaterials Associated Infection

Verlag: Springer New York

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Abstract

Introduction: Ventilator-associated pneumonia (VAP) is problematic because of its frequency, morbidity, and mortality. Many strategies have been studied in an attempt to reduce the rate of VAP. This chapter provides a comprehensive review of silver-coated endotracheal tubes in the prevention of VAP.
Methods: Two silver-coated endotracheal tubes have been studied in comparison with similar, uncoated tubes—each beginning with preclinical models and progressing to clinical studies. One is commercially available (Agento® IC, C. R. Bard, Covington, Georgia, United States) and is coated with silver ions micro-dispersed in a proprietary hydrophilic polymer. The other remains investigational and is prepared by submerging a standard endotracheal tube into silver sulfadiazine (with or without chlorhexidine) and polyurethane.
Results: Both silver-coated tubes were active in preclinical models designed to mimic surrogate endpoints for VAP, such as in vitro bacterial adherence, biofilm formation, and bacterial burden in animal models. Both tubes were active in phase 2 studies of patients requiring mechanical ventilation. The commercially available tube was active in a randomized, phase 3 study and reduced the incidence of microbiologically confirmed VAP at any time after intubation (silver vs. uncoated, 37/766 [4.8 %] vs. 56/743 [7.5 %]; P = 0.03; relative risk reduction, 35.9 %) and within 10 days of intubation (27/766 [3.5 %] vs. 50/743 [6.7 %]; P = 0.005, relative risk reduction, 47.6 %).
Conclusions: The silver-coated endotracheal tube is a promising strategy for preventing VAP. The commercially available tube meets the standards for evidence-based guidelines because effectiveness is supported by the results of a well-designed, phase 3 study. In addition, the device is suitable for use in the intensive care unit because it becomes user independent after intubation and does not add to the burden of busy healthcare providers.

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Vorheriges Kapitel Topical Antimicrobial-Containing Biomaterials for Peri-Implant Infections in the Oral Cavity
Literatur
1.
Rosenthal VD, Maki DG, Salomao R, et al. Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med. 2006;145:582–91.
2.
Rosenthal VD, Maki DG, Jamulitrat S et al. International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003–2008, issued June 2009. Am J Infect Control. 2010;38:95–104 e102.
3.
Anderson DJ, Kirkland KB, Kaye KS, et al. Underresourced hospital infection control and prevention programs: penny wise, pound foolish? Infect Control Hosp Epidemiol. 2007;28:767–73.CrossRef
4.
Kuti EL, Patel AA, Coleman CI. Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associated pneumonia and blood stream infection: a meta-analysis. J Crit Care. 2008;23:91–100.CrossRef
5.
Michael S. Niederman, Donald E, et al. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171:388–416.
6.
File Jr TM. Recommendations for treatment of hospital-acquired and ventilator-associated pneumonia: review of recent international guidelines. Clin Infect Dis. 2010;51 Suppl 1:S42–7.CrossRef
7.
Coffin SE, Klompas M, Classen D, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29 Suppl 1:S31–40.CrossRef
8.
Muscedere J, Dodek P, Keenan S, Fowler R, Cook D, Heyland D. Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: diagnosis and treatment. J Crit Care. 2008;23:138–47.CrossRef
9.
Rotstein C, Evans G, Born A, et al. Clinical practice guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia in adults. Can J Infect Dis Med Microbiol. 2008;19:19–53.
10.
Torres A, Ewig S, Lode H, Carlet J. Defining, treating and preventing hospital acquired pneumonia: European perspective. Intensive Care Med. 2009;35:9–29.CrossRef
11.
Masterton RG, Galloway A, French G, et al. Guidelines for the management of hospital-acquired pneumonia in the UK: report of the working party on hospital-acquired pneumonia of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 2008;62:5–34.CrossRef
12.
Kollef M. SMART approaches for reducing nosocomial infections in the intensive care unit. Chest. 2008;134:447–56.CrossRef
13.
Craven DE. Preventing ventilator-associated pneumonia in adults: sowing seeds of change. Chest. 2006;130:251–60.CrossRef
14.
National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990–May 1999, issued June 1999. Am J Infect Control. 1999;27:520–532.
15.
National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32:470–485.
16.
Edwards JR, Peterson KD, Mu Y et al. National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009. Am J Infect Control. 2009;37:783–805.
17.
Cook D. Ventilator associated pneumonia: perspectives on the burden of illness. Intensive Care Med. 2000;26 Suppl 1:S31–7.CrossRef
18.
Rello J, Lorente C, Bodi M, Diaz E, Ricart M, Kollef MH. Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?: a survey based on the opinions of an international panel of intensivists. Chest. 2002;122:656–61.CrossRef
19.
Ricart M, Lorente C, Diaz E, Kollef MH, Rello J. Nursing adherence with evidence-based guidelines for preventing ventilator-associated pneumonia. Crit Care Med. 2003;31:2693–6.CrossRef
20.
Cason CL, Tyner T, Saunders S, Broome L. Nurses’ implementation of guidelines for ventilator-associated pneumonia from the Centers for Disease Control and Prevention. Am J Crit Care. 2007;16:28–36. discussion 37; quiz 38.
21.
Kaynar AM, Mathew JJ, Hudlin MM, et al. Attitudes of respiratory therapists and nurses about measures to prevent ventilator-associated pneumonia: a multicenter, cross-sectional survey study. Respir Care. 2007;52:1687–94.
22.
Cook D, Ricard JD, Reeve B, et al. Ventilator circuit and secretion management strategies: a Franco-Canadian survey. Crit Care Med. 2000;28:3547–54.CrossRef
23.
Cabana MD, Rand CS, Powe NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–65.CrossRef
24.
Zack JE, Garrison T, Trovillion E, et al. Effect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia. Crit Care Med. 2002;30:2407–12.CrossRef
25.
Babcock HM, Zack JE, Garrison T, et al. An educational intervention to reduce ventilator-associated pneumonia in an integrated health system: a comparison of effects. Chest. 2004;125:2224–31.CrossRef
26.
Apisarnthanarak A, Pinitchai U, Thongphubeth K, et al. Effectiveness of an educational program to reduce ventilator-associated pneumonia in a tertiary care center in Thailand: a 4-year study. Clin Infect Dis. 2007;45:704–11.CrossRef
27.
Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD. The 100,000 lives campaign: setting a goal and a deadline for improving health care quality. JAMA. 2006;295:324–7.CrossRef
28.
Zilberberg MD, Shorr AF, Kollef MH. Implementing quality improvements in the intensive care unit: ventilator bundle as an example. Crit Care Med. 2009;37:305–9.CrossRef
29.
Bird D, Zambuto A, O’Donnell C, et al. Adherence to ventilator-associated pneumonia bundle and incidence of ventilator-associated pneumonia in the surgical intensive care unit. Arch Surg. 2010;145:465–70.CrossRef
30.
Hawe CS, Ellis KS, Cairns CJ, Longmate A. Reduction of ventilator-associated pneumonia: active versus passive guideline implementation. Intensive Care Med. 2009;35:1180–6.CrossRef
31.
Bouadma L, Mourvillier B, Deiler V, et al. A multifaceted program to prevent ventilator-associated pneumonia: impact on compliance with preventive measures. Crit Care Med. 2010;38:789–96.CrossRef
32.
Zaydfudim V, Dossett LA, Starmer JM, et al. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Arch Surg. 2009;144:656–62.CrossRef
33.
Morrow LE, Kollef MH. Recognition and prevention of nosocomial pneumonia in the intensive care unit and infection control in mechanical ventilation. Crit Care Med. 2010;38:S352–62.CrossRef
34.
Shorr AF, Micek ST, Jackson Jr WL, Kollef MH. Economic implications of an evidence-based sepsis protocol: can we improve outcomes and lower costs? Crit Care Med. 2007;35:1257–62.CrossRef
35.
Petering HG. Pharmacology and toxicology of heavy metals: silver. Pharmacol Ther. 1976;1:127–30.
36.
Saint S, Elmore JG, Sullivan SD, Emerson SS, Koepsell TD. The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis. Am J Med. 1998;105:236–41.CrossRef
37.
Ahearn DG, Grace DT, Jennings MJ, et al. Effects of hydrogel/silver coatings on in vitro adhesion to catheters of bacteria associated with urinary tract infections. Curr Microbiol. 2000;41:120–5.CrossRef
38.
Gabriel MM, Sawant AD, Simmons RB, Ahearn DG. Effects of silver on adherence of bacteria to urinary catheters: in vitro studies. Curr Microbiol. 1995;30:17–22.CrossRef
39.
Chandra J, Patel JD, Li J, et al. Modification of surface properties of biomaterials influences the ability of Candida albicans to form biofilms. Appl Environ Microbiol. 2005;71:8795–801.CrossRef
40.
Cunliffe D, Smart CA, Alexander C, Vulfson EN. Bacterial adhesion at synthetic surfaces. Appl Environ Microbiol. 1999;65:4995–5002.
41.
Patel JD, Ebert M, Ward R, Anderson JM. S. epidermidis biofilm formation: effects of biomaterial surface chemistry and serum proteins. J Biomed Mater Res A. 2007;80:742–51.
42.
Tebbs SE, Elliott TS. Modification of central venous catheter polymers to prevent in vitro microbial colonisation. Eur J Clin Microbiol Infect Dis. 1994;13:111–7.CrossRef
43.
Berra L, De Marchi L, Yu ZX, Laquerriere P, Baccarelli A, Kolobow T. Endotracheal tubes coated with antiseptics decrease bacterial colonization of the ventilator circuits, lungs, and endotracheal tube. Anesthesiology. 2004;100:1446–56.CrossRef
44.
Berra L, Curto F, Li Bassi G, et al. Antimicrobial-coated endotracheal tubes: an experimental study. Intensive Care Med. 2008;34:1020–9.CrossRef
45.
Berra L, Kolobow T, Laquerriere P, et al. Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: a clinical trial. Intensive Care Med. 2008;34:1030–7.CrossRef
46.
Rello J, Afessa B, Anzueto A, et al. Activity of a silver-coated endotracheal tube in preclinical models of ventilator-associated pneumonia and a study after extubation. Crit Care Med. 2010;38:1135–40.CrossRef
47.
Olson ME, Harmon BG, Kollef MH. Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs. Chest. 2002;121:863–70.CrossRef
48.
Grier N. Silver and its compounds. In: Block SS, editor. Disinfection, sterilization, and preservation. 2nd ed. Philadelphia: Lea & Febiger; 1997. p. 395–407.
49.
Rello J, Kollef M, Diaz E, et al. Reduced burden of bacterial airway colonization with a novel silver-coated endotracheal tube in a randomized multiple-center feasibility study. Crit Care Med. 2006;34:2766–72.CrossRef
50.
Perrelli G, Piolatto G. Tentative reference values for gold, silver and platinum: literature data analysis. Sci Total Environ. 1992;120:93–6.CrossRef
51.
Wan AT, Conyers RA, Coombs CJ, Masterton JP. Determination of silver in blood, urine, and tissues of volunteers and burn patients. Clin Chem. 1991;37:1683–7.
52.
Feldman C, Kassel M, Cantrell J, et al. The presence and sequence of endotracheal tube colonization in patients undergoing mechanical ventilation. Eur Respir J. 1999;13:546–51.CrossRef
53.
Kollef MH, Afessa B, Anzueto A, et al. Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia. The NASCENT Randomized Trial. JAMA. 2008;300:805–14.CrossRef
54.
Afessa B, Shorr AF, Anzueto AR, Craven DE, Schinner R, Kollef MH. Association between a silver-coated endotracheal tube and reduced mortality in patients with ventilator-associated pneumonia. Chest. 2010;137:1015–21.CrossRef
55.
Fagon JY, Chastre J, Domart Y, et al. Nosocomial pneumonia in patients receiving continuous mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis. 1989;139:877–84.
56.
Fagon JY, Chastre J, Hance AJ, Montravers P, Novara A, Gibert C. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med. 1993;94:281–8.CrossRef
57.
Kollef MH, Silver P, Murphy DM, Trovillion E. The effect of late-onset ventilator-associated pneumonia in determining patient mortality. Chest. 1995;108:1655–62.CrossRef
58.
Rello J, Jubert P, Valles J, Artigas A, Rue M, Niederman MS. Evaluation of outcome for intubated patients with pneumonia due to Pseudomonas aeruginosa. Clin Infect Dis. 1996;23:973–8.CrossRef
59.
Shorr AF, Zilberberg MD, Kollef M. Cost-effectiveness analysis of a silver-coated endotracheal tube to reduce the incidence of ventilator-associated pneumonia. Infect Control Hosp Epidemiol. 2009;30:759–63.CrossRef
60.
Morrow LE, Jarrett JE, Malesker MA, Kollef MH. Systematic use of a silver-coated endotracheal tube reduces rates of venitlator-associated pneumnia (poster 2146). San Diego, CA: American Thoracic Society International Conference; 2009.
61.
Morrow LE, Jarrett JE, Malesker MA, Kollef MK. Effect of a silver-coated endotracheal tube on ventilator-associated pneumonia and medical resource utilization in clinical practice (poster 388). Society of Critical Care Medicine’s 39th Critical Care Congress. Miami Beach, FL, 2010
62.
Morrow LE, Mintz EP, Malesker MA. Effect of a silver-coated endotracheal tube on ventilator-associated pneumonia and medical resource utilization in clinical practice (poster 983). Fifth Decennial International Conference on Healthcare-Associated Infections. Atlanta, GA, 2010
63.
Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med. 2005;33:2184–93.CrossRef
Metadaten
Titel
Preventive Strategies in VAP: Focus on Silver-Coated Endotracheal Tubes
verfasst von
Marin Kollef
Copyright-Jahr
2013
Verlag
Springer New York
Buch
Biomaterials Associated Infection

Print ISBN: 978-1-4614-1030-0

Electronic ISBN: 978-1-4614-1031-7

Copyright-Jahr: 2013

DOI
https://doi.org/10.1007/978-1-4614-1031-7_21

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