A randomized trial of 2% chlorhexidine tincture compared with 10% aqueous povidone–iodine for venipuncture site disinfection: Effects on blood culture contamination rates

Suwanpimolkul, Gompol; Pongkumpai, Montri; Suankratay, Chusana

doi:10.1016/j.jinf.2008.03.001

Cited by 61 publications

(40 citation statements)

References 19 publications

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“…CDC, Atlanta also has recommended the use of 2% chlorhexidine glutamate as a skin disinfection before invasive procedures. 17,18 We, in our study, have reported a slight preponderance of females over males although this difference was not significant. Also, the other demographic details like age, height and weight were similar in both the groups, so had no significant difference.…”

Section: Discussioncontrasting

confidence: 67%

Comparison of chlorhexidine with povidone - iodine solution for skin disinfection in epidural and central venoues catheter insertion

Rao¹,

Rao²

2016

Int J Adv Med

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Section: Discussioncontrasting

confidence: 67%

Comparison of chlorhexidine with povidone - iodine solution for skin disinfection in epidural and central venoues catheter insertion

Rao¹,

Rao²

2016

Int J Adv Med

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“…Nevertheless, the reported rates of contamination vary from 0.8% to over 8% among institutions. Almost half of all positive results were reported to be contaminants at some institutions (1,4,15,18,20,23,24,26,31). With such a high contamination rate, it is not easy to interpret the results properly for clinicians.…”

mentioning

confidence: 99%

Isopropyl Alcohol Compared with Isopropyl Alcohol plus Povidone-Iodine as Skin Preparation for Prevention of Blood Culture Contamination

et al. 2009

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Despite a number of studies on the efficacies of antiseptics for the prevention of blood culture contamination, it still remains unclear which antiseptic should be used. Although the combination of povidone-iodine and isopropyl alcohol has been traditionally used in many institutions, the application of povidone-iodine needs extra time, and there is little evidence that this combination could have an additive effect in reducing contamination rates. To elucidate the additive efficacy of povidone-iodine, we compared two antiseptics, 70% isopropyl alcohol only and 70% isopropyl alcohol plus povidone-iodine, in a prospective, nonrandomized, and partially blinded study in a community hospital in Japan between 1 October 2007 and 21 March 2008. All blood samples for culture were drawn by first-year residents who received formal training on collection techniques. Skin antisepsis was performed with 70% isopropyl alcohol plus povidone-iodine on all inpatient wards and with only 70% isopropyl alcohol in the emergency department. For the group of specimens from inpatient wards cultured, 13 (0.46%) of 2,797 cultures were considered contaminated. For the group of specimens from the emergency department cultured, 12 (0.42%) of 2,856 cultures were considered contaminated. There was no significant difference in the contamination rates between the two groups (relative risk, 0.90; 95% confidence interval, 0.41 to 1.98; P ‫؍‬ 0.80). In conclusion, the use of a single application of 70% isopropyl alcohol is a sufficient and a more cost-and time-effective method of obtaining blood samples for culture than the use of a combination of isopropyl alcohol and povidone-iodine. The extremely low contamination rates in both groups suggest that the type of antiseptic used may not be as important as the use of proper technique.The collection of blood samples for culture is essential for the diagnosis and management of patients with suspected bacteremia, and the importance of this practice has recently been reconfirmed in the Clinical and Laboratory Standards Institute's guideline Principles and Procedure for Blood Cultures in 2007 (5). However, the problem of false-positive results due to contamination has remained since the beginning of the use of modern techniques over 70 years ago. Contamination most commonly occurs when exogenous bacteria are inoculated into the culture medium from the patient's skin, the phlebotomist's hands, or phlebotomy kits. Contamination rates below 3% are generally considered acceptable (5, 9). Nevertheless, the reported rates of contamination vary from 0.8% to over 8% among institutions. Almost half of all positive results were reported to be contaminants at some institutions (1,4,15,18,20,23,24,26,31). With such a high contamination rate, it is not easy to interpret the results properly for clinicians. Consequently, contaminated blood cultures lead to extra costs because of the unnecessary use of antibiotics, prolonged hospitalization, and the subsequent possible development of antimicrobial resistance (3,15,23,25...

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“…Based on reports by the American Society for Microbiology, the rate of blood culture contamination should not exceed 3% [8] . Based on the findings of previous studies, we suggest the following methods for reducing the blood culture contamination rate in NICU: (1) Strict adherence to using dedicated phlebotomists or medical technologists to collect cultures [24,25] ; trained phlebotomy or blood culture teams can decrease blood culture contamination rates [26][27][28] . (2) Adherence to a sterile venipuncture technique [11] ; skin of the patient at the site where the cultures are obtained is the most common source of contamination, so adequate skin preparation is highly recommended before percutaneous collection of the blood specimen [23,29] .…”

Section: Discussionmentioning

confidence: 99%

Blood Culture Contamination in a Neonatal Intensive Care Unit in Shiraz, Southwest-Central Iran

2011

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Objective: To measure bacterial contamination rates in blood culture specimens and distinguish sepsis from blood culture contamination in newborn hospitalized patients in a neonatal intensive care unit and to recognize the most commonly isolated bacteria. Materials and Methods: Blood samples of 578 neonates were collected and cultured throughout the year of study (March 2006 to February 2007). Isolated bacteria were identified by traditional biochemical tests. Clinical criteria combined with laboratory data were used to differentiate the contaminated cultures from clinically significant cultures. Results: Of the 578 neonatal blood culture samples, 78 (13.49%) were positive for bacteria, and 49 isolates (8.47%) were classified as contaminants. Pseudomonas aeruginosa and Staphylococcus aureus were the most common isolates from true bacteremia, and Staphylococcus epidermidis and diphtheroids were the most common contaminants. Conclusion: The blood culture contamination rate in our studied neonatal intensive care unit was high. A variety of measures are recommended for reducing the rate of blood culture contamination to avoid undesirable outcomes associated with blood culture contamination.

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A randomized trial of 2% chlorhexidine tincture compared with 10% aqueous povidone–iodine for venipuncture site disinfection: Effects on blood culture contamination rates

Cited by 61 publications

References 19 publications

Comparison of chlorhexidine with povidone - iodine solution for skin disinfection in epidural and central venoues catheter insertion

Comparison of chlorhexidine with povidone - iodine solution for skin disinfection in epidural and central venoues catheter insertion

Isopropyl Alcohol Compared with Isopropyl Alcohol plus Povidone-Iodine as Skin Preparation for Prevention of Blood Culture Contamination

Blood Culture Contamination in a Neonatal Intensive Care Unit in Shiraz, Southwest-Central Iran

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