OBJECTIVE: To compare the effectiveness for prevention of central venous and arterial catheter colonization of 3 skin antisepsis with 1 of 3 antiseptic solutions: 10% aqueous povidone iodine (aqueous PI), 2% aqueous chlorhexidine gluconate (aqueous CG), and 0.5% alcoholic chlorhexidine gluconate (alcoholic CG). DESIGN: Prospective, randomized controlled trial. SETTING:Intensive care unit in a teaching hospital. METHODS: Patients were randomly assigned to 1 of the 3 skin antisepsis groups. The distal tips of catheters were semiquantitatively cultured when the catheters were no longer necessary or if there was a suspicion of catheter-related infection. Rates of catheter colonization, catheter-related sepsis, and catheter-related bacteremia were compared among the 3 groups. RESULTS:A total of 631 catheters were included in the study (194 from the aqueous PI group, 211 from the aqueous CG group, and 226 from the alcoholic CG group). The incidence of catheter colonization was significantly lower in the alcoholic CG than in the aqueous PI group (14.2% vs 24.7%; relative risk, 0.5 [95% confidence interval, 0.3-0.8; P < .01]); it was also significantly lower in the aqueous CG group than in the aqueous PI group (16.1% vs 24.7%; relative risk, 0.6 [95% confidence interval, 0.4-0.9; P = .03]). There were no significant differences between the aqueous CG and the alcoholic CG groups. Incidences of catheter-related bacteremia were similar for all 3 groups. The aqueous and alcoholic CG solutions were superior to the aqueous PI solution in preventing catheter colonization due to gram-positive bacteria. CONCLUSIONS: The aqueous and alcoholic CG solutions for cutaneous antisepsis were similarly effective in preventing colonization of central venous catheters and arterial catheters. Both had significantly lower incidences of colonization than did the aqueous PI solution; this effect seems to be related to the CG solutions' more efficacious prevention of colonization with gram-positive bacteria.
RCT Entities:
OBJECTIVE: To compare the effectiveness for prevention of central venous and arterial catheter colonization of 3 skin antisepsis with 1 of 3 antiseptic solutions: 10% aqueous povidone iodine (aqueous PI), 2% aqueous chlorhexidine gluconate (aqueous CG), and 0.5% alcoholic chlorhexidine gluconate (alcoholic CG). DESIGN: Prospective, randomized controlled trial. SETTING: Intensive care unit in a teaching hospital. METHODS:Patients were randomly assigned to 1 of the 3 skin antisepsis groups. The distal tips of catheters were semiquantitatively cultured when the catheters were no longer necessary or if there was a suspicion of catheter-related infection. Rates of catheter colonization, catheter-related sepsis, and catheter-related bacteremia were compared among the 3 groups. RESULTS: A total of 631 catheters were included in the study (194 from the aqueous PI group, 211 from the aqueous CG group, and 226 from the alcoholic CG group). The incidence of catheter colonization was significantly lower in the alcoholic CG than in the aqueous PI group (14.2% vs 24.7%; relative risk, 0.5 [95% confidence interval, 0.3-0.8; P < .01]); it was also significantly lower in the aqueous CG group than in the aqueous PI group (16.1% vs 24.7%; relative risk, 0.6 [95% confidence interval, 0.4-0.9; P = .03]). There were no significant differences between the aqueous CG and the alcoholic CG groups. Incidences of catheter-related bacteremia were similar for all 3 groups. The aqueous and alcoholic CG solutions were superior to the aqueous PI solution in preventing catheter colonization due to gram-positive bacteria. CONCLUSIONS: The aqueous and alcoholic CG solutions for cutaneous antisepsis were similarly effective in preventing colonization of central venous catheters and arterial catheters. Both had significantly lower incidences of colonization than did the aqueous PI solution; this effect seems to be related to the CG solutions' more efficacious prevention of colonization with gram-positive bacteria.
Authors: R Peredo; C Sabatier; A Villagrá; J González; C Hernández; F Pérez; D Suárez; J Vallés Journal: Eur J Clin Microbiol Infect Dis Date: 2010-06-10 Impact factor: 3.267
Authors: T J Karpanen; T Worthington; B R Conway; A C Hilton; T S J Elliott; P A Lambert Journal: Antimicrob Agents Chemother Date: 2009-01-21 Impact factor: 5.191
Authors: Myriam K S Ballo; Sami Rtimi; César Pulgarin; Nancy Hopf; Aurélie Berthet; John Kiwi; Philippe Moreillon; José M Entenza; Alain Bizzini Journal: Antimicrob Agents Chemother Date: 2016-08-22 Impact factor: 5.191
Authors: Li Zhang; Kadaba S Sriprakash; David McMillan; John R Gowardman; Bharat Patel; Claire M Rickard Journal: BMC Microbiol Date: 2010-10-19 Impact factor: 3.605
Authors: Nai Ming Lai; Nai An Lai; Elizabeth O'Riordan; Nathorn Chaiyakunapruk; Jacqueline E Taylor; Kenneth Tan Journal: Cochrane Database Syst Rev Date: 2016-07-13