Chlorhexidine gluconate transparent dressing does not decrease central line‐associated bloodstream infection in critically ill patients: A randomized controlled trial

Abstract

Background: Central line-associated blood stream infections are accompanied by increased mortality and health care costs. The application of different types of dressings in infection control has not been fully investigated to date. Aim:To assess the effects of two different dressing types on central line-associated bloodstream infections. Methods:A randomized, nonblinded, controlled trial was conducted. Central lines were randomly allocated to intervention (chlorhexidine gluconate transparent dressing, n = 259) and control groups (standard dressing, n = 215). The central line-associated bloodstream infection rate was assessed.Results: A statistically nonsignificant difference was noted in the overall central line-associated bloodstream infection rates between the two groups. The frequency of dressing changes in the patients with the chlorhexidine gluconate transparent dressing was significantly lower than that in the patients with a standard dressing.The predominant type of infectious microorganisms isolated from the central lineassociated bloodstream infection episodes was Gram-negative bacteria (57.2%).Gram-positive bacteria and fungi were noted at lower percentages (28.5% and 14.3%, respectively). Conclusion:The use of a chlorhexidine gluconate transparent dressing does not decrease the central line-associated bloodstream infection rate, although it decreases the frequency of dressing changes so may save nursing time.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis

“…The selected studies included 18 RCTs 19-36 and 2 quasi-experimental studies, 37,38 and all of them were performed in hospital settings. Furthermore, 6 studies were multicentric (≥ 2 hospitals), [19][20][21][22][23]27 14 studies were performed on adults, [20][21][22][23][24][25][27][28][29]31,[33][34][35]38 and 6 studies examined neonates or pediatric populations. 19,26,30,32,36,37 Of the studies with this information, 13 included ICU patients, 19,[21][22][23][24][25][26]29,32,[34][35][36][37] 4 included onco-hematological patients, 27,30,31,33 and 1 included non-ICU patients.…”

“…28 The definition of CRBSI, exit-site and tunnel infections, and adverse events varied across the studies (Appendix 4 online). Also, 5 studies reported CRBSI rates ≥ 2.0 per 1,000 catheter days 21,25,27,30,35 in at least one study group and 2 studies reported CRBSI rates <1.5 per 1,000 catheter days in both groups. 22,23…”

“…Among studies with available data, 11 included short-term CVCs, 21,[24][25][26][27]29,32,33,[35][36][37] 3 included long-term CVCs, 30,31,38 3 included CVCs and arterial catheters, 20,22,23 1 included long and short-term CVCs, 19 and 1 included PICC lines. 28 In addition, 2 studies used antimicrobial-impregnated catheters.…”

“…Femoral insertions represented ≥44% of catheters in 3 studies. 21,26,35 One study used different skin antiseptics (alcohol versus povidoneiodine) in each study arm, 19 and another study applied daily CHG bathing in all patients. 24 Also, 3 studies used >0.5% of CHG skin preparation before catheter insertion.…”

Desinfektion, Waschen, Kleben: Vermeiden von Infektionen auf der Intensivstation

“…Vor jeglichen Manipulationen an einem ZVK sowie mit ihm verbundenen Dreiwegehähnen muss eine hygienische Händedesinfektion sowie eine Desinfektion des Dreiwegehahns durchgeführt werden [7] [20]. In anderen gab es keine signifikante Reduktion der katheterassoziierten Blutstrominfektionen [21]. In weiteren Studien konnte eine Reduktion auch mit Verbänden ohne aseptischen Wirkstoff mit nachhaltigem Effekt erzielt werden.…”