Background: Although several potential risk factors have been discussed, risk factors associated with bacterial colonization or even infection of catheters used for regional anaesthesia are not very well investigated.

Introduction. Bacterial colonization of catheter tips is common in regional anesthesia and is a suspected risk factor for infectious complications. This is the first study evaluating the effect of CHG-impregnated dressings on bacterial colonization of regional anesthesia catheters in a routine clinical setting. Methods. In this prospective study, regional anesthesia catheter infection rates were examined in two groups of patients with epidural and peripheral regional catheters. In the first group, regional anesthesia was dressed with a conventional draping. The second group of patients underwent catheter dressing using a CHG-impregnated draping. Removed catheters and the insertion sites were both screened for bacterial colonization. Results. A total of 337 catheters from 308 patients were analysed. There was no significant reduction of local infections in either epidural or peripheral regional anesthesia catheters in both CHG and conventional groups. In the conventional group, 21% of the catheter tips and 41% of the insertion sites showed positive culture results. In the CHG-group, however, only 3% of the catheter tips and 8% of the insertion sites were colonised. Conclusion. CHG dressings significantly reduce bacterial colonization of the tip and the insertion site of epidural and peripheral regional catheters. However, no reductions in rates of local infections were seen.

It is estimated for the year 2006 that around 500,000 to 600,000 nosocomial infections occurred in Germany and that among these 10,000 to 15,000 patients died of the infection. Nosocomial infections in general lengthen the duration of hospitalisation by on average 4 days - with associated extra costs of 4000 to 20,000 Euro per case. About a third of all infections acquired in hospital are considered to be avoidable. However, the classification of an infection as nosocomial does not automatically mean that a causal relationship exists between a medical intervention and the occurrence of the infection. Also a nosocomial infection is not a synonym for medical or nursing errors. The first epidemiological report of the EU emphasises the health-political and health-economical significance of nosocomial infections and classifies the increasing number of infections acquired in hospitals as a most important danger - even higher than the threats of pandemic influenza and HIV.

In this case-control study we could not detect any evidence for an increased risk for SSI after a single-dose of dexamethasone (4-8 mg) in gynecological patients.

According to §23 of the prevention of infections act (Infektionsschutzgesetzes, IfSG), the directors of hospitals and facilities for ambulant operations are obliged to continuously record and evaluate nosocomial infections. In this way it is intended that quality management with regard to the prevention of nosocomial infections should be improved. The national reference centre for the surveillance of nosocomial infections (NRC) has developed a computer and internet-assisted system and made it available: the hospital infection surveillance system (KISS). With this method at hand it is now possible to conduct a uniform surveillance of nosocomial infections that takes the most important influencing and risk factors into consideration and thus permits orienting comparisons. Participation in the KISS is possible free of charge.