Chlorhexidine IV dressing research
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.
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.