Chlorhexidine gluconate or polyhexamethylene biguanide disc dressing to reduce the incidence of central-line-associated bloodstream infection: a feasibility randomized controlled trial (the CLABSI trial)

Webster, Joan; Larsen, Emily; Marsh, Nicole; Choudhury, Abu; Harris, Patrick N A; Rickard, Claire M

doi:10.1016/j.jhin.2017.04.009

Cited by 22 publications

(18 citation statements)

References 21 publications

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“…3A. Twenty-five RCTs [19,20,22,23,31–41,44–47,53,54–58] (7090 patients) reported the incidence of CRBSI and included all 10 dressings (CHG, BDD, AD, TD, SPU, SDG, SAD, OD, NTD, and HD). The result indicated that TD (odds ratio [OR] 0.35, 95% CrI 0.14, 0.89) was statistically significantly more effective than the other dressings in preventing CRBSI.…”

Section: Resultsmentioning

confidence: 99%

“…[18] Among them, the chlorhexidine gluconate (CHG)-impregnated dressing is the most commonly used; it is simple to use, breathable, transparent, and has a cost comparable to that of standard film dressing currently used on insertion sites. [19] Other dressings, such as the transparent dressing (TD), bordered polyurethane dressing (BPU), and silver alginate dressing (SAD), are also used to prevent catheter infection. [20–23] It has been suggested that CVC antibacterial dressings can inhibit the colonization of microorganisms on the surface of the catheter and prevent them from spreading into the bloodstream.…”

Section: Introductionmentioning

confidence: 99%

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Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Dang¹,

Li²,

Tian³

2019

Medicine

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Purpose: The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related blood infections (CRBSI) and rank these antimicrobial dressings for practical consideration. Methods: We searched the PubMed, Cochrane library, Embase, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared dressings for prevention of CRBSI. Two authors independently extracted data from each included RCT according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the WinBUGS (V.1.4.3) and the Stata (V.15.0). Results: Finally, 35 RCTs involving 8494 patients and evaluating 13 dressings were included. Network meta-analysis showed that transparent dressing may be the best way to prevent CRBSI. Suture and bordered polyurethane dressing might have the lowest risk of CRBSI rate per 1000 catheter-days, and sutureless securement device might lead to the lowest incidence of catheter failure. Conclusions: This network meta-analysis indicated that transparent dressings may be selected for the prevention of CRBSI in patients with central venous catheters, which is of importance in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used dressings in this field.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Dang¹,

Li²,

Tian³

2019

Medicine

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“…[23][24][25] PHMB is also used as an antimicrobial to prevent wound infection and medical device-related infection. 26 It is also thought to have antimicrobial activity through binding to and disrupting the bacterial cell wall; however, other research has shown inhibition of cell replication, indicating it may bind to bacterial DNA. 27 In this study, the antimicrobial activity of the test articles was assessed using the ZOI method.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Poloxamer-Based Wound Dressings on Acinetobacter baumanni Biofilms

Salisbury¹,

Mullin²,

Chen³

et al. 2019

Advances in Wound Care

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This study evaluated the antimicrobial and antibiofilm activity of a concentrated surfactant gel preserved with antimicrobials and a concentrated surfactant gel with 1% silver sulfadiazine (SSD) against 12 clinical strains of Acinetobacter baumannii and the type strain A. baumannii ATCC 19606. Approach: The biofilm-forming potential of the A. baumannii isolates was investigated using a crystal violet assay and classifying the isolates as ''nonadherent,'' ''weak,'' ''moderate,'' or ''strong'' biofilm formers. The antimicrobial activity was determined using the zone of inhibition (ZOI) method. The antibiofilm activity was evaluated against A. baumannii ATCC 19606 using the Center for Disease Control bioreactor model. Results: A. baumannii readily forms biofilms with 8 out of the 12 clinical isolates being classified as strong biofilm formers (OD 570 > 0.4). The concentrated surfactant gel with 1% SSD demonstrated antimicrobial activity against all isolates with a ZOI of 7.2-14 mm. Antibiofilm activity against a 24 h biofilm of A. baumannii ATCC 19606 was found, with a ‡7 log decrease in bacterial cell density following 24 h treatment with the concentrated surfactant gel with 1% SSD. The concentrated surfactant gel preserved with antimicrobials also showed some biofilm disruption with *3 log decrease in bacterial cell density being found. Innovation: The concentrated surfactant gel with 1% SSD used in this study showed antimicrobial and antibiofilm activity against A. baumannii. Conclusion: The concentrated surfactant gel with 1% SSD used in this study showed efficacy against A. baumannii, a common cause of wound infections, and should be considered for treatment of wounds infected with A. baumannii in health care settings.

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“…Chlorhexidine is highly cationic, and one of its advantages is its binding and strong adhesion to most areas, which causes this substance to release gradually and slowly after consumption within a certain time frame to constantly provide an antimicrobial environment. This has resulted in a better and more lasting effect of chlorhexidine than other washing solutions used in ICUs (26). Concerning the mechanism of action, chlorhexidine has a positive electric charge while bacteria are negative; then, it binds to the body of bacteria and destroys their cytoplasm, or stops their growth.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

et al. 2020

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Background: Urinary tract infection is the most common site of infection associated with health care in the Intensive Care Unit (ICU) patients. Long-term catheterization is the most important risk factor for Urinary Tract Infections (UTIs). These infections are more common in women than in men. Colonized microorganisms in the perineal skin and around the urethra may move into the urinary system through the external surfaces of the urinary catheter to cause infection. Objectives: The present study aimed to compare the effect of perineal care with normal saline and 2% chlorhexidine solution on the rate of catheter-associated urinary tract infection (CAUTI) in women hospitalized in ICUs. Methods: A quasi-experimental study was performed on 70 female patients hospitalized in the ICU of Khatam-Al-Anbia Hospital of Zahedan in 2019. The research units meeting the inclusion criteria were selected using convenience sampling and then randomly divided into two groups of normal saline (n = 35) and chlorhexidine (n = 35). The perineal area of patients in the first group was washed with normal saline and the second group with 2% chlorhexidine solutions twice a day for seven days in both groups. To diagnose UTIs, urine samples were cultured on the first and seventh days. Data were analyzed using SPSS 21 via the independent t-test, chi-square test, and Fisher’s exact test at a significance level of less than 0.05. Results: Finally, 60 participants completed the study. The two groups did not differ significantly in terms of age, marital status, level of education, cause of hospitalization, antibiotic use, underlying diseases, fluid intake, and urinary output. At the end of the seventh day after the intervention, the incidence of UTIs was significantly lower in the chlorhexidine group (13.3%) than in the normal saline group (76.7%) (P = 0.001). Conclusions: The results showed that washing the perineal area every 12 hours with 2% chlorhexidine solution compared to normal saline reduces the incidence of CAUTIs in women hospitalized in ICUs. Therefore, perineal care with a 2% chlorhexidine solution is recommended for perineal care of female patients with urinary catheters hospitalized in ICUs.

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Chlorhexidine gluconate or polyhexamethylene biguanide disc dressing to reduce the incidence of central-line-associated bloodstream infection: a feasibility randomized controlled trial (the CLABSI trial)

Cited by 22 publications

References 21 publications

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Efficacy of Poloxamer-Based Wound Dressings on Acinetobacter baumanni Biofilms

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

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