Comparison of chlorhexidine impregnated dressing and standard dressing for the prevention of central‐line associated blood stream infection and colonization in critically ill pediatric patients: A randomized controlled trial

Abstract

Objective: The purpose of this study is to compare chlorhexidine gluconate (CHG)-impregnated dressing and standard dressing with respect to their effects on the frequency of central-line associated bloodstream infection (CLABSI), catheter related bloodstream infection (CRBSI), primary bloodstream infection (BSI) and catheter colonization in critically ill pediatric patients with short-term central venous catheter.Methods: Prospective, single-center randomized controlled trial performed in pediatric intensive care unit (PICU) of a tertiary referral hospital. The patients were randomized with respect to the type of catheter xation they had received, either with CHG-impregnated dressing or standard dressing.Results: A total of 307 patients (151 CHG-impregnated dressing, 156 standard dressing), with 307 catheters amounting to a collective total of 4993 catheter days, were included in the study. Use of CHG impregnated dressing did not signi cantly decrease the incidence of CLABSI (6.36 per 1000 catheter days vs. 7.59 per 1000 catheter days; HR: 0.93, P = 0.76), CRBSI (3.82 per 1000 catheter days vs. 4.18 per 1000 catheter days; HR: 0.98, P = 0.98), primary BSI (2.54 per 1000 catheter days vs. 3.42 catheter days; HR: 0.39, P = 0.67).CHG-impregnated dressing signi cantly decreased the incidence of catheter colonization (3.82 per 1000 catheter days vs. 7.59 per 1000 catheter days; HR: 0.40, P = 0.04). Longer catheter time-in-place and use of blood product transfusion were found to be independently associated with CLABSI.Conclusions: The use of CHG-impregnated dressing does not signi cantly decrease CLABSI incidence in critically ill pediatric patients compared to standard dressing, but it is effective in reducing catheter colonization.

Central Line Associated Blood Stream Infection: Microbiological Profile and its Antimicrobial Susceptibility Pattern at Tertiary Care Centre

“…Gram-positive cocci were the most predominant colonisers of central lines, as said in other research. 13,14 Among the 150 cases, the most common site for central line catheter insertion was subclavian (50%), followed by jugular (40%), and femoral (10%). Out of 40 cases of CLABSI, the highest percentage of infection was discovered in the femoral catheter (80%), [15][16][17] followed by the jugular catheter (60%) and the subclavian catheter (30%), with a p-value of <0.0031, which was statistically significant and was calculated by the Chi-square test.…”