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"The use of CHG-impregnated dressing does not decrease CLABSI incidence in critically ill pediatric patients, but it significantly reduced catheter colonization" Duyu et al (2021).

Chlorhexidine IV dressing research

Abstract:

Background: The aim of this study was to compare chlorhexidine gluconate (CHG)-impregnated dressing and standard dressing with respect to the frequency of central-line associated bloodstream infection (CLABSI), catheter related bloodstream infection (CRBSI), primary bloodstream infection (BSI) and catheter colonization in critically ill pediatric patients with short-term central venous catheter (CVC).

Methods: Children admitted to the PICU of a tertiary institution, between May 2018 and December 2019, and received placement of a short-term CVC were included in this single-center randomized controlled trial. Patients were grouped according to the type of catheter fixation applied.

Results: A total of 307 patients (151 CHG-impregnated dressing, 156 standard dressing), with 307 catheters (amounting to a collective total of 4993 catheter days), were included in the study. CHG-impregnated dressing did not significantly decrease the incidence of CLABSI (6.36 vs. 7.59 per 1000 catheter days; HR:0.93, P=0.76), CRBSI (3.82 vs. 4.18 per 1000 catheter days; HR:0.98; P=0.98), and primary BSI (2.54 vs. 3.42 catheter days; HR:0.79; P=0.67). CHG-impregnated dressing significantly decreased the incidence of catheter colonization (3.82 vs. 7.59 per 1000 catheter days; HR:0.40; P=0.04). In both groups, the most frequent microorganisms isolated in CLABSI or catheter colonization were gram positive bacteria (the majority were coagulase-negative staphylococci).

Conclusions: The use of CHG-impregnated dressing does not decrease CLABSI incidence in critically ill pediatric patients, but it significantly reduced catheter colonization. Coagulase-negative staphylococci were the most common microorganisms causing CLABSI or catheter colonization.


Reference:

Duyu M, Karakaya Z, Yazici P, Yavuz S, Yersel NM, Tascilar MO, Firat N, Bozkurt O, Caglar Mocan Y. Chlorhexidine-impregnated dressing RCT for central-line associated bloodstream infection in critically-ill pediatric patients. Pediatr Int. 2021 Oct 5. doi: 10.1111/ped.15011. Epub ahead of print. PMID: 34610185.