Chlorhexidine-impregnated gel dressing compared with transparent polyurethane dressing in the prevention of catheter-related infections in critically ill adult patients: A pilot randomised controlled trial

Margatho, Amanda Salles; Ciol, Márcia A.; Hoffman, Jeanne M.; Reis, Paula Elaine Diniz dos; Furuya, Rejane Kiyomi; Lima, Dennisani A.F.S.; Basile-Filho, Aníbal; Silveira, Renata Cristina de Campos Pereira

doi:10.1016/j.aucc.2018.11.001

Cited by 8 publications

(15 citation statements)

References 26 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Types Of Catheters and Insertion Practicesmentioning

confidence: 99%

“…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. 28,35,37 Maximal sterile barrier precautions were cited in 14 studies.…”

Section: Types Of Catheters and Insertion Practicesmentioning

confidence: 99%

“…28,35,37 Maximal sterile barrier precautions were cited in 14 studies. 19,[21][22][23][24][25][26]29,30,[32][33][34][35][36]…”

Section: Types Of Catheters and Insertion Practicesmentioning

confidence: 99%

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

Puig-Asensio

Marra

Childs

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: To evaluate the effectiveness of chlorhexidine (CHG) dressings to prevent catheter-related bloodstream infections (CRBSIs). Design: Systematic review and meta-analysis. Methods: We searched PubMed, CINAHL, EMBASE, and ClinicalTrials.gov for studies (randomized controlled and quasi-experimental trials) with the following criteria: patients with short- or long-term catheters; CHG dressings were used in the intervention group and nonantimicrobial dressings in the control group; CRBSI was an outcome. Random-effects models were used to obtain pooled risk ratios (pRRs). Heterogeneity was evaluated using the I2 test and the Cochran Q statistic. Results: In total, 20 studies (18 randomized controlled trials; 15,590 catheters) without evidence of publication bias and mainly performed in intensive care units (ICUs) were included. CHG dressings significantly reduced CRBSIs (pRR, 0.71; 95% CI, 0.58–0.87), independent of the CHG dressing type used. Benefits were limited to adults with short-term central venous catheters (CVCs), including onco-hematological patients. For long-term CVCs, CHG dressings decreased exit-site/tunnel infections (pRR, 0.37; 95% CI, 0.22–0.64). Contact dermatitis was associated with CHG dressing use (pRR, 5.16; 95% CI, 2.09–12.70); especially in neonates and pediatric populations in whom severe reactions occurred. Also, 2 studies evaluated and did not find CHG-acquired resistance. Conclusions: CHG dressings prevent CRBSIs in adults with short-term CVCs, including patients with an onco-hematological disease. CHG dressings might reduce exit-site and tunnel infections in long-term CVCs. In neonates and pediatric populations, proof of CHG dressing effectiveness is lacking and there is an increased risk of serious adverse events. Future studies should investigate CHG effectiveness in non-ICU settings and monitor for CHG resistance.

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Section: Resultsmentioning

confidence: 99%

Section: Types Of Catheters and Insertion Practicesmentioning

confidence: 99%

Section: Types Of Catheters and Insertion Practicesmentioning

confidence: 99%

“…28,35,37 Maximal sterile barrier precautions were cited in 14 studies. 19,[21][22][23][24][25][26]29,30,[32][33][34][35][36]…”

Section: Types Of Catheters and Insertion Practicesmentioning

confidence: 99%

See 2 more Smart Citations

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

Puig-Asensio

Marra

Childs

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…Este estudo é um recorte transversal de um ensaio clínico aleatorizado 8 cujos participantes foram alocados no grupo experimental (denominado grupo de clorexidina gel) e controle (grupo poliuretano). Os dados relacionados à avaliação do curativo, avaliação da pele e swab da pele do sítio de inserção do cateter dos dois grupos foram utilizados para o presente estudo.…”

Section: Metodologiaunclassified

Perfil microbiológico da colonização do sítio de inserção do cateter venoso central considerando dois curativos transparentes

Pereira

Margatho

Lima

et al. 2020

Medicina (Ribeirao Preto Online)

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Modelo do Estudo: estudo transversal da fase prospectiva de um ensaio clínico. Objetivo: identificar os microrganismos e a sensibilidade antimicrobiana no sítio de inserção do cateter venoso central coberto pelo curativo gel de clorexidina ou pelo filme transparente de poliuretano. Metodologia: estudo transversal, descritivo, realizado com adultos críticos no período de abril a dezembro de 2014 em um hospital universitário no interior do estado de São Paulo. Imediatamente após a retirada do curativo, foi coletada amostra de swab da pele do sítio de inserção do cateter, semeado em placas de Agar sangue e Agar MacConkey e incubadas em estufas bacteriológicas a 35 °C. Nas amostras que apresentaram crescimento bacteriano após 24 horas de incubação, foram realizados testes de sensibilidade aos antimicrobianos utilizando o equipamento automatizado Vitek II (Biomerieux®). Resultados: 45 pacientes fizeram uso do curativo gel de clorexidina e 47 utilizaram o filme transparente de poliuretano. No grupo com o curativo gel de clorexidina houve crescimento dos microrganismos Acinetobacter baumannii, Pseudomonas aeruginosa, Morganella morganii, Enterobacter cloacae, Staphylococcus aureus e Staphylococcus epidermidis em 13 amostras de swabs. O Staphylococcus aureus apresentou resistência a oxacilina. No grupo do filme transparente de poliuretano seis amostras foram positivas com o crescimento de Serratia marcescens, Acinetobacter baumannii, Staphylococcus epidermidis, Staphylococcus haemolyticus e Klebsiella pneumoniae, esta resistente a amicacina (Klebsiella pneumoniae carbapenemase - KPC). Conclusão: os resultados demonstram maior crescimento bacteriano no sítio de inserção do cateter venoso central coberto pelo curativo gel de clorexidina quando comparado ao filme transparente de poliuretano.

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The Future of Emergent Vascular Access

Paxton

Corsi

Szydlowski

2021

Emergent Vascular Access

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Chlorhexidine-impregnated gel dressing compared with transparent polyurethane dressing in the prevention of catheter-related infections in critically ill adult patients: A pilot randomised controlled trial

Cited by 8 publications

References 26 publications

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

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

Perfil microbiológico da colonização do sítio de inserção do cateter venoso central considerando dois curativos transparentes

The Future of Emergent Vascular Access

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