Prospective randomized trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters

Maki, Dennis G.; Ringer, Marilyn; Alvarado, Carla J.

doi:10.1016/0196-6553(94)90073-6

Cited by 62 publications

(84 citation statements)

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“…11 To date there have been no randomized trials showing CHG to be more efficacious than PI in preventing CRBSI in neonates. Because most adult CVC are in place less than 7 days, adequate cutaneous antisepsis before catheter placement will effectively prevent most CRBSI.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Recent trials in adults and neonates suggest that a cutaneous chlorhexidine gluconate (CHG) scrub before central venous catheter (CVC) or peripheral catheter insertion may be more effective than PI for prevention of CRBSI in adults and catheter colonization in neonates. [10][11][12][13] No current CHG-based antiseptic has been approved by the Federal Drug Administration (FDA) for use in neonates for intravenous catheter placement.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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Objective: The purpose of this pilot trial was to determine whether rates of contact dermatitis following cutaneous antisepsis for central catheter placement were similar among neonates treated with chlorhexidine gluconate and povidone-iodine. Chlorhexidine gluconate absorption was also evaluated.Study Design: Infants weighing X1500 g and X7 days of age were randomized to a 10% povidone-iodine or 2% chlorhexidine gluconate site scrub before catheter placement. Primary outcomes evaluated included dermatitis, catheter colonization and chlorhexidine gluconate absorption.Result: A total of 48 neonates were enrolled. Colonization rates were similar among treatment groups (P<0.6). Dermatitis did not occur at chlorhexidine gluconate (central catheters, n ¼ 24; peripheral catheters, n ¼ 29) sites. Seven neonates had measurable chlorhexidine gluconate concentrations (range 13 to 100 ng ml À1 ) during catheterization. Conclusion:In this small trial chlorhexidine gluconate antisepsis was tolerated by study neonates. Chlorhexidine gluconate was cutaneously absorbed. Larger trials are needed to determine efficacy and tolerance of chlorhexidine gluconate in neonates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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“…The collection of skin material was performed on the seventh day and after fourteen days of the catheter insertion, with a sterile saline pre-wet swab over a 20 cm 2 area. The swab was put into a tube with 1 mL sterile saline and then stirred in a vortex; about 0.1mL of the liquid was inoculated in Blood Agar plates which were incubated at 35ºC for 24 h. Cultures were considered positive if a growth of ≥ 200 UFC/ 20 cm 2 was seen [10].…”

Section: Microbiological Techniquesmentioning

confidence: 99%

Etiology and pathogenesis of bloodstream infections associated with the use of long-term central vascular catheter (CVC) in patients who undergone gastrointestinal surgery

Brito¹,

Gondim²,

Filho³

et al. 2007

Braz J Infect Dis

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CVC is the main factor of risk of bloodstream infections. This study purpose was determining both etiology and pathogenesis of these infections in 80 patients who undergone gastrointestinal surgery and who worn long lasting CVC, in the institution HC-UFU. Cultures were made in nostril, skin of the insertion site, tip and catheter hub, in addition to hemoculture in those suspects of sepsis. The colonization incidence rate of the catheter tip was 12.5/ 1,000 catheter days and the CVC associate infection rate was 3.1/1,000 catheter days. Frequencies of skin, hub and catheter tip colonization were 13.8%, 8.9% and 13.3%, respectively. Coagulase-negative Staphylococci were the most found microorganisms in nostril (74%), skin (45.4%) and hub (75%) and Gram-negative bacilli (50%), followed by S. aureus (25%) the most common ones in catheter tip. Approximately 51% of patients received antibiotics and most of them (53.7%) had therapeutic purpose. The frequency of patients with clinical sepsis was 27.5%. Three cases of bacteremia associated with the use of CVC were detected (3.8%), with S. aureus in two of them and K. pneumoniae in the third one. There was not seen any association of skin and hub colonization with their presence in the catheter tip and in the blood of these patients, but S. aureus was recovered from nostril of those with sepsis by this pathogenic agent. A greater concern is suggested over preventive measures and control of these primary and secondary bloodstream, as well as catheter tip colonization.

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“…The rate of complications, chiefly infections, may be reduced when an aseptic technique is used for catheter manipulation. 10 The aim of this study was to assess the complication rates of and reasons for access failure in a group of children and adolescents on HD in the city of Belo Horizonte (MG), Brazil.…”

Section: Introductionmentioning

confidence: 99%

Avaliação do acesso vascular para hemodiálise em crianças e adolescentes: um estudo de coorte retrospectivo de 10 anos

Souza¹,

Oliveira²,

Silva³

et al. 2011

J. Bras. Nefrol.

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Prospective randomized trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters

Cited by 62 publications

References 0 publications

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

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

Etiology and pathogenesis of bloodstream infections associated with the use of long-term central vascular catheter (CVC) in patients who undergone gastrointestinal surgery

Avaliação do acesso vascular para hemodiálise em crianças e adolescentes: um estudo de coorte retrospectivo de 10 anos

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