Chlorhexidine gluconate transparent dressing does not decrease central line-associated bloodstream infection in critically ill patients: A randomized controlled trial

被引:1
作者
Yu, Kunrong [1 ]
Lu, Meishan [2 ]
Meng, Yanling [3 ]
Zhao, Yanwei [4 ]
Li, Zheng [5 ]
机构
[1] Peking Union Med Coll & Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Pulm & Crit Care Med Ward, Beijing, Peoples R China
[2] Peking Union Med Coll & Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Hlth Care, 1 Shuaifuyuan, Beijing 100730, Peoples R China
[3] Peking Union Med Coll & Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Med ICU, Beijing, Peoples R China
[4] Peking Union Med Coll & Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Nursing, Beijing, Peoples R China
[5] Peking Union Med Coll, Sch Nursing, Beijing, Peoples R China
关键词
central line-associated bloodstream infections; chlorhexidine; critical care; dressing; nursing; CATHETER-RELATED INFECTIONS; INTENSIVE-CARE UNITS; SAFETY NETWORK; PREVENTION; GUIDELINES; PROGRAM; ADULTS; RATES;
D O I
10.1111/ijn.12776
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Background Central line-associated blood stream infections are accompanied by increased mortality and health care costs. The application of different types of dressings in infection control has not been fully investigated to date. Aim To assess the effects of two different dressing types on central line-associated bloodstream infections. Methods A randomized, nonblinded, controlled trial was conducted. Central lines were randomly allocated to intervention (chlorhexidine gluconate transparent dressing, n = 259) and control groups (standard dressing, n = 215). The central line-associated bloodstream infection rate was assessed. Results A statistically nonsignificant difference was noted in the overall central line-associated bloodstream infection rates between the two groups. The frequency of dressing changes in the patients with the chlorhexidine gluconate transparent dressing was significantly lower than that in the patients with a standard dressing. The predominant type of infectious microorganisms isolated from the central line-associated bloodstream infection episodes was Gram-negative bacteria (57.2%). Gram-positive bacteria and fungi were noted at lower percentages (28.5% and 14.3%, respectively). Conclusion The use of a chlorhexidine gluconate transparent dressing does not decrease the central line-associated bloodstream infection rate, although it decreases the frequency of dressing changes so may save nursing time.
引用
收藏
页数:8
相关论文
共 27 条
[11]   Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America [J].
Mermel, Leonard A. ;
Allon, Michael ;
Bouza, Emilio ;
Craven, Donald E. ;
Flynn, Patricia ;
O'Grady, Naomi P. ;
Raad, Issam I. ;
Rijnders, Bart J. A. ;
Sherertz, Robert J. ;
Warren, David K. .
CLINICAL INFECTIOUS DISEASES, 2009, 49 (01) :1-45
[12]   Factors predicting the cause and prognosis of central line-associated bloodstream infections [J].
Nemoto, Takaaki ;
Kunishima, Hiroyuki ;
Shimizu, Gohji ;
Hirose, Masanori ;
Yamasaki, Yukitaka ;
Nishisako, Hisashi ;
Takagi, Taeko ;
Matsuda, Takahide .
JOURNAL OF INFECTION AND CHEMOTHERAPY, 2015, 21 (1-2) :118-122
[13]  
O'Grady NP, 2011, CLIN INFECT DIS, V52, pE162, DOI [10.1093/cid/cir257, 10.1016/j.ajic.2011.01.003]
[14]  
Olson C., 2008, Journal of the Association for Vascular Access, V13, P13, DOI [DOI 10.2309/JAVA.13-1-4, 10.2309/java.13-1-4]
[15]  
Pfaff Barbara, 2012, Crit Care Nurse, V32, P35, DOI 10.4037/ccn2012956
[16]  
Roberts B, 1998, Aust Crit Care, V11, P16, DOI 10.1016/S1036-7314(98)70426-6
[17]   International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009 [J].
Rosenthal, Victor D. ;
Hu Bijie ;
Maki, Dennis G. ;
Mehta, Yatin ;
Apisarnthanarak, Anucha ;
Medeiros, Eduardo A. ;
Leblebicioglu, Hakan ;
Fisher, Dale ;
Alvarez-Moreno, Carlos ;
Abu Khader, Ilham ;
Gonzalez Martinez, Marisela Del Rocio ;
Cuellar, Luis E. ;
Anne Navoa-Ng, Josephine ;
Abouqal, Redouane ;
Guanche Garcell, Humberto ;
Mitrev, Zan ;
Pirez Garcia, Maria Catalina ;
Hamdi, Asma ;
Duenas, Lourdes ;
Cancel, Elsie ;
Gurskis, Vaidotas ;
Rasslan, Ossama ;
Ahmed, Altaf ;
Kanj, Souha S. ;
Chavarria Ugalde, Olber ;
Mapp, Trudell ;
Raka, Lul ;
Meng, Cheong Yuet ;
Le Thi Anh Thu ;
Ghazal, Sameeh ;
Gikas, Achilleas ;
Pazmino Narvaez, Leonardo ;
Mejia, Nepomuceno ;
Hadjieva, Nassya ;
Elanbya, May Osman Gamar ;
Guzman Siritt, Maria Eugenia ;
Jayatilleke, Kushlani .
AMERICAN JOURNAL OF INFECTION CONTROL, 2012, 40 (05) :396-407
[18]  
Rupp M. E., 2008, PROSPECTIVE RANDOMIZ
[19]   Reducing the rate of catheter-associated bloodstream infections in a surgical intensive care unit using the Institute for Healthcare Improvement central line bundle [J].
Sacks, Greg D. ;
Diggs, Brian S. ;
Hadjizacharia, Pantelis ;
Green, Donald ;
Salim, Ali ;
Malinoski, Darren J. .
AMERICAN JOURNAL OF SURGERY, 2014, 207 (06) :817-823
[20]   Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis [J].
Safdar, Nasia ;
O'Horo, John C. ;
Ghufran, Aiman ;
Bearden, Allison ;
Didier, Maria Eugenia ;
Chateau, Dan ;
Maki, Dennis G. .
CRITICAL CARE MEDICINE, 2014, 42 (07) :1703-1713