Prospective evaluation of a multi-factorial prevention strategy on the impact of nosocomial infection in very-low-birthweight infants

Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates

“…Occlusiveness, pressure created by the dressing, CHG or a combination of all three factors may have been responsible for episodes of severe contact dermatitis at the dressing sites. In a time sequence trial to evaluate a multifactorial approach to reduce CRBSI, Andersen et al 22 noted that 4 of 36 (11%) neonates <1000 g developed contact dermatitis after a 2% aqueous chlorhexidine scrub. There were no episodes of contact dermatitis in 49 study neonates who were X1000 g. In our trial there were no episodes of dermatitis at the 53 catheter sites of relatively mature (32.41±2.9 weeks), heavy (2085±846 g) neonates.…”

Neonatal Infectious Diseases

“…Catheter bundles that include guidelines for insertion and management of central-lines have been shown to reduce risk of central line associated bloodstream infection. 99–102 The use of heparin for prevention of line infections has been successful in single center randomized studies, but has not been confirmed in larger multicenter studies; therefore, its routine use is not recommended. 103,104 Daily check lists that document continued need for central lines to reduce duration of line use and a goal of zero central-line associated infections should be the responsibility of the whole healthcare team.…”

Safety of chlorhexidine gluconate used for skin antisepsis in the preterm infant

“…One study of a 2% aqueous topical CHG solution in neonates <1000 g and <48 h of age noted that 4 of 36 (11%) developed severe skin irritation; 3 of 4 were noted to have erythema alone but one infant developed skin breakdown and exudation. 28 A recent case report also identified an infant born at 25 weeks gestation who sustained skin burns after exposure to a 2% aqueous CHG solution before umbilical catheter placement in the first few hours of life. 29 The most common reported event after CHG exposure is skin irritation.…”