Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on Central Line–Associated Bloodstream Infections

Quach, Caroline; Milstone, Aaron M.; Perpête, Chantal; Bonenfant, Mario; Moore, Dorothy; Perreault, Thérèse

doi:10.1086/674862

Cited by 54 publications

(60 citation statements)

References 36 publications

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“…It should be noted that the mean dwell time in their study was 14 d, compared to a mean dwell time in our group of infants of 8.8 d, with a median of 8 d and mode 6 d. None of the infants involved in our study developed CLABSI. Several centers have successfully implemented strategies for the reduction of CLABSIs with PICC line placement (21)(22)(23). While it is important to consider the risks of central line placement, the necessity of optimal nutrient delivery should also be considered.…”

Section: Discussionmentioning

confidence: 99%

Peripherally inserted central catheters optimize nutrient intake in moderately preterm infants

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Peripherally inserted central catheters optimize nutrient intake in moderately preterm infants

et al. 2016

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“…Mengingat telah banyak penelitian terkait efektivitas sibin setiap hari dengan menggunakan chlorhexidine gluconate dalam pencegahan CLABSI pada orang dewasa di ruang ICU. (Quach et al, 2014b) menyebutkan bahwa kejadian CLABSI tetap tinggi di NICU RS Anak Montreal, Kanada meskipun telah menggunakan CHG saat prosedur pemasangan maupun dalam pemeliharaan CVC. Oleh karenanya, pada penelitiannya Quach dkk mencoba mengaplikasikan sibin harian menggunakan CHG di NICU.…”

Section: (Clabsi/central Line Associated Bloodstream Infection)unclassified

“…Yaitu dengan sibin harian menggunakan 2% chlorhexidine gluconate (CHG) untuk mengurangi resiko infeksi aliran darah (BSIs) (Bleasdale et al, 2007;Climo et al, 2013;Derde, Dautzenberg, & Bonten, 2012;Karki & Cheng, 2012;Me, Rj, Lyden, Control, & Epidemiology, 2012;Milstone et al, 2013;MunozPrice et al, 2012;O'Horo, Silva, Munoz-Price, & Safdar, 2012;Popovich, Hota, Hayes, Weinstein, & Hayden, 2009;Quach et al, 2014b;Sievert, Armola, & Halm, 2011).…”

Section: Hasilmentioning

confidence: 99%

“…Untuk itu dibutuhkan studi prospektif untuk menentukan sub-populasi di NICU yang aman dan efektif. Berdasarkan data survey tersebut, Quach et al (2014) (Quach et al, 2014b) Hasil dari penelitiannya, terjadi penurunan kejadian CLABSI. DUR (Device Utilization Ratio) juga menurun, namun tidak jelas apakah karena sibin dengan CHG atau konsekuensi dari penurunan kejadian CLABSI.…”

Section: Pembahasanunclassified

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The Use of 2% Chlorhexidine Gluconate (Chg) as a Daily Bathing to Reduce Bacteremia in Children With Critical Illness at Picu/Nicu

Khasanah

2016

Nurscope

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ABSTRAKLatar belakang: Bakteremia seringkali terjadi karena infeksi nosokomial yang sebenarnya dapat dicegah. Pada anak-anak yang dirawat di rumah sakit biasanya memiliki resiko lebih tinggi untuk mengalaminya. Terutama pada anak dengan sakit kritis yang berada di Pediatric Intensive Care Unit (PICU) dimana pada keadaan tersebut anak mendapatkan indikasi pemasangan kateter vena sentral. Tujuan: Menganalisis penggunaan 2% Chlorhexidine Gluconate (CHG) sebagai perawatan sibin harian untuk mengurangi bakteremia pada anak dengan sakit kritis di PICU/NICU. Pembahasan: Studi tentang penggunaan 2% CHG untuk perawatan sibin pasien sakit kritis yang dirawat di ruang perawatan intensif telah dilakukan pada pasien dewasa. Berkembang penelitian yang dilakukan pada anak, dari penelitian ini merekomendasikan pemanfaatan 2% CHG untuk sibin harian dapat digunakan pada pasien tertentu di NICU ketika sudah ada upaya dengan tindakan lain namun masih gagal untuk mengurangi kejadian CLABSI. Kesimpulan: Penerapan rekomendasi akan melibatkan persetujuan melalui struktur organisasi yang tepat yang berwenang dalam mengawasi perubahan praktek. Untuk mengembangkan prosedur sibin harian dengan 2% CHG di ruang perawatan intensif agar menurunkan kejadian bakteremia, diperlukan staff yang dapat memahami petunjuk tentang penggunaan CHG.Kata Kunci: Chlorhexidine Gluconate, Sibin harian, Bakteremia pada anak, PICU/NICU. THE USE OF 2% CHLORHEXIDINE GLUCONATE (CHG) AS A DAILY BATHING TO REDUCE BACTEREMIA IN CHILDREN WITH CRITICAL ILLNESS AT PICU/NICU ABSTRACT Background: Bacteremia frequently occurs because of nosocomial infection that actually could be preventable. In children who are hospitalized ussually have a higher risk to experience it. Especially in children with critical illness at Pediatric Intensive Care Unit (PICU) at which the state of children to get an indication of central venous catheters (CVC

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“…The second hospital had a stable rate of CLABSI throughout the study period, with rates of 5.32/ 1,000 catheter days in 2009 and 6.39, 5.41, 2.65, and 4.35/1,000 catheter days for each of the following years, respectively (22). Additionally, we studied the levels of antibiotic resistance and clinical data to compare and identify differences between S. epidermidis isolates from the two hospitals.…”

mentioning

confidence: 99%

Molecular Epidemiology of a Vancomycin-Intermediate Heteroresistant Staphylococcus epidermidis Outbreak in a Neonatal Intensive Care Unit

Chong

Quach

Blanchard

et al. 2016

Antimicrob Agents Chemother

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epidermidis CLABSIs were identified in two tertiary care NICUs in Quebec, Canada. Decreased vancomycin susceptibility was identified in about 88% of all collected strains using Etest methods. However, discrepancies were found according to the Etest and population analysis profiling-area under the concentration-time curve (PAP-AUC) methods used. All strains were susceptible to linezolid, and a few isolates were nonsusceptible to daptomycin. Great genetic diversity was observed within the collection, with 31 pulsed-field gel electrophoresis (PFGE) patterns identified. The outbreak strains were all determined to be heteroresistant to vancomycin and were polyclonal. The study identified two major clones, PFGE patterns E and G, which were found in both NICUs across the 5-year study period. This suggests the persistence of highly successful clones that are well adapted to the hospital environment. hV S. epidermidis seems more common than currently realized in the NICU, and certain hV S. epidermidis clones can become endemic to the NICU. The reservoirs for these clones remain unknown at this time, and identification of the reservoirs is needed to better understand the impact of hV S. epidermidis in the NICU and to inform infection prevention strategies. In addition, there is a need to investigate and validate hV determination protocols for different species of CoNS.

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Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on Central Line–Associated Bloodstream Infections

Abstract: BACKGROUND. Despite implementation of recommended best practices, our central line-associated bloodstream infection (CLABSI) rates remained high. Our objective was to describe the impact of chlorhexidine gluconate (CHG) bathing on CLABSI rates in neonates.

Cited by 54 publications

References 36 publications

Peripherally inserted central catheters optimize nutrient intake in moderately preterm infants

Peripherally inserted central catheters optimize nutrient intake in moderately preterm infants

The Use of 2% Chlorhexidine Gluconate (Chg) as a Daily Bathing to Reduce Bacteremia in Children With Critical Illness at Picu/Nicu

Molecular Epidemiology of a Vancomycin-Intermediate Heteroresistant Staphylococcus epidermidis Outbreak in a Neonatal Intensive Care Unit

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