Use of a Chlorhexidine Dressing to Reduce Microbial Colonization of Epidural Catheters

Shapiro, Jeffrey; Bond, Emmett L.; Garman, J. Kent

doi:10.1097/00000542-199010000-00007

Cited by 68 publications

(34 citation statements)

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“…Mann et al (2001) demonstrated a colonization rate of 42.3% in controls versus 3.45% in patients randomized to the chlorhexidine disc (p = 0.001). Shapiro et al (1990) produced similar results (29.0% VS 3.8%; p<0.05). CRBSIs were not evaluated in these studies.…”

Section: Effectiveness Of Chlorhexidine-impregnated Discs In Outpatiesupporting

confidence: 62%

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Daniels

Frei²

2012

American Journal of Infectious Diseases

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Problem statement: Healthcare-associated infections are the 5th leading cause of death in the United States. Catheter-Related Bloodstream Infections (CRBSIs) comprise 14% of all healthcareassociated infections and contribute to increased mortality and financial costs. Antimicrobialimpregnated sponge discs to be used surrounding the catheter insertion site are a newer addition to the options available for the prevention of catheter-related infections. Approach: This review critically appraises the literature regarding the utility of antimicrobial-impregnated discs. We performed a literature search using the MEDLINE (1948-November 2011) database. Only controlled clinical trials were included and the electronic database search was performed using the following MeSH and keyword search terms: ("Biopatch" or "chlorhexidine") and ("dressing" or "sponge") and ("catheter"). Results: Our search yielded eight trials. Chlorhexidine-impregnated discs are effective in preventing catheter colonization in hospitalized patients and outpatients; however, effectiveness in preventing CRBSIs may be limited to hospitalized, critically ill patients. Although many studies have evaluated the effectiveness of several pharmaceutical agents for the prevention of catheter-related infections, there are still significant gaps in the literature regarding these infections, including the effectiveness of Polyhexamethylene Biguanide (PHMB)-impregnated discs and the cost-effectiveness of PHMBimpregnated discs compared to chlorhexidine-impregnated discs. It is also unclear if antimicrobialimpregnated discs are effective in specific populations, like in outpatients, patients at high risk compared to low risk patients and patients with long-term catheters. Conclusion: Chlorhexidineimpregnated discs should be utilized for the duration of catheterization in high risk, critically ill patients and in hospitals where catheter-related infection rates are persistently high despite other preventative strategies. Futher investigation of the effectiveness of these discs in other populations and of other antimicrobial-impregnated discs is needed.

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Section: Effectiveness Of Chlorhexidine-impregnated Discs In Outpatiesupporting

confidence: 62%

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Daniels

Frei²

2012

American Journal of Infectious Diseases

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“…CHX dressings (Biopatch) have also been shown to reduce colonization of exit sites of epidural catheters. 8 CHX gluconate used as catheter-site skin antisepsis has been shown to reduce catheter-related bloodstream infections by nearly 50% in a large meta-analysis of over 4000 catheters. 13 In the adult intensive care setting, CHX skin disinfection repeated 48 hourly reduced the incidence of local infections and intravascularcatheter-related bacteraemias of central venous catheter and arterial catheters.…”

Section: Discussionmentioning

confidence: 99%

“…8 CHX is well established as an effective antiseptic agent for handwashing and skin cleansing prior to catheter insertion. 9 It is also safe and effective as topical treatment of mucosal surfaces including the mouth and vagina.…”

Section: Introductionmentioning

confidence: 99%

Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial

Chambers

Sanders

Patton

et al. 2005

Journal of Hospital Infection

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“…Shapiro et al 284 showed a significant reduction in catheter colonization when using a chlorhexidine dressing. Bacterial filters have been advocated to reduce infection rates.…”

Section: Image Available In Print Onlymentioning

confidence: 99%

Long-term spinal analgesic delivery: A review of the preclinical and clinical literature

Wallace

Yaksh

2000

Regional Anesthesia and Pain Medicine

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Use of a Chlorhexidine Dressing to Reduce Microbial Colonization of Epidural Catheters

Cited by 68 publications

References 0 publications

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial

Long-term spinal analgesic delivery: A review of the preclinical and clinical literature

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