PURPOSE: The reduction of central venous line (CVL)-associated bloodstream infections (CLABSIs) is generally advocated. However, despite implementing infection prevention recommendations, CLABSI rates remain high at some institutions. Therefore, a chlorhexidine-containing dressing should be assessed for its potential for infection reduction, adverse events (AEs) and practicability. METHODS: The number of CVLs, CVL days, CLABSIs and CLABSI rates with regard to the kind of dressing (standard vs. chlorhexidine-containing) were documented from November 2010 to may 2012 (1,298 patients with 12,220 CVL days) at two intensive care units (ICUs) and compared to historical controls. The practicability and safety of the chlorhexidine-containing dressing and reasons for not using this dressing were assessed. RESULTS: Forty CLABSIs occurred in 34 patients, resulting in a significantly lower overall CLABSI rate in patients with the chlorhexidine-containing dressing [1.51/1,000 CVL days; confidence interval (CI): 0.75-2.70] compared to patients with the standard dressing (5.87/1,000 CVL days; CI: 3.93-8.43; p < 0.0001). The CLABSI rate in historical controls receiving the standard dressing was 6.2/1,000 CVL days. The main reason for not using chlorhexidine-containing dressing was bleeding at the insertion site. AEs occurred in five patients and represented self-healing skin macerations (3 cases) and superficial skin necrosis (2 cases). CONCLUSIONS: In case of high CLABSI rates despite the implementation of standard recommendations, our findings suggest that a chlorhexidine-containing dressing safely decreases CLABSI rates.
PURPOSE: The reduction of central venous line (CVL)-associated bloodstream infections (CLABSIs) is generally advocated. However, despite implementing infection prevention recommendations, CLABSI rates remain high at some institutions. Therefore, a chlorhexidine-containing dressing should be assessed for its potential for infection reduction, adverse events (AEs) and practicability. METHODS: The number of CVLs, CVL days, CLABSIs and CLABSI rates with regard to the kind of dressing (standard vs. chlorhexidine-containing) were documented from November 2010 to may 2012 (1,298 patients with 12,220 CVL days) at two intensive care units (ICUs) and compared to historical controls. The practicability and safety of the chlorhexidine-containing dressing and reasons for not using this dressing were assessed. RESULTS: Forty CLABSIs occurred in 34 patients, resulting in a significantly lower overall CLABSI rate in patients with the chlorhexidine-containing dressing [1.51/1,000 CVL days; confidence interval (CI): 0.75-2.70] compared to patients with the standard dressing (5.87/1,000 CVL days; CI: 3.93-8.43; p < 0.0001). The CLABSI rate in historical controls receiving the standard dressing was 6.2/1,000 CVL days. The main reason for not using chlorhexidine-containing dressing was bleeding at the insertion site. AEs occurred in five patients and represented self-healing skin macerations (3 cases) and superficial skin necrosis (2 cases). CONCLUSIONS: In case of high CLABSI rates despite the implementation of standard recommendations, our findings suggest that a chlorhexidine-containing dressing safely decreases CLABSI rates.
Authors: Jonathan R Edwards; Kelly D Peterson; Yi Mu; Shailendra Banerjee; Katherine Allen-Bridson; Gloria Morrell; Margaret A Dudeck; Daniel A Pollock; Teresa C Horan Journal: Am J Infect Control Date: 2009-12 Impact factor: 2.918
Authors: Alexandre R Marra; Ruy Guilherme Rodrigues Cal; Marcelino Souza Durão; Luci Correa; Luciana Reis Guastelli; Denis Faria Moura; Michael B Edmond; Oscar Fernando Pavão Dos Santos Journal: Am J Infect Control Date: 2010-03-12 Impact factor: 2.918
Authors: David K Warren; Wasim W Quadir; Christopher S Hollenbeak; Alexis M Elward; Michael J Cox; Victoria J Fraser Journal: Crit Care Med Date: 2006-08 Impact factor: 7.598
Authors: Deborah S Yokoe; Leonard A Mermel; Deverick J Anderson; Kathleen M Arias; Helen Burstin; David P Calfee; Susan E Coffin; Erik R Dubberke; Victoria Fraser; Dale N Gerding; Frances A Griffin; Peter Gross; Keith S Kaye; Michael Klompas; Evelyn Lo; Jonas Marschall; Lindsay Nicolle; David A Pegues; Trish M Perl; Kelly Podgorny; Sanjay Saint; Cassandra D Salgado; Robert A Weinstein; Robert Wise; David Classen Journal: Infect Control Hosp Epidemiol Date: 2008-10 Impact factor: 3.254
Authors: E Yoko Furuya; Andrew Dick; Eli N Perencevich; Monika Pogorzelska; Donald Goldmann; Patricia W Stone Journal: PLoS One Date: 2011-01-18 Impact factor: 3.240
Authors: Arne Simon; Rhoikos Furtwängler; Norbert Graf; Hans Jürgen Laws; Sebastian Voigt; Brar Piening; Christine Geffers; Philipp Agyeman; Roland A Ammann Journal: GMS Hyg Infect Control Date: 2016-05-12