Chlorhexidine-Impregnated Dressing for Prevention of Colonization of Central Venous Catheters in Infants and Children

Levy, Itzhak; Katz, Jacob; Solter, Ester; Samra, Zmira; Vidne, Bernardo A.; Birk, Einat; Ashkenazi, Shai; Dagan, Ovadia

doi:10.1097/01.inf.0000172934.98865.14

Cited by 133 publications

(135 citation statements)

References 27 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Levy et al [7] investigated 166 infants and children between 0 and 18 years from a cardiac intensive care unit. The mean catheterization duration was given with 4.5 days, and follow-up data were missing.…”

Section: Discussionmentioning

confidence: 99%

“…BioPatch® (Ethicon, Norderstedt, Germany) is a chlorhexidineimpregnated sponge (2.5 cm diameter) which can be placed over the CVC insertion site and is covered by a transparent polyurethane dressing. There have been favourable results in paediatric patients undergoing CVC insertion regarding the rates of catheter tip colonization [6,7]. A randomized study of 33 individuals did not reveal a decrease in catheter tip colonizations and CVC-related infection [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

et al. 2008

View full text Add to dashboard Cite

The objective of the study was to evaluate the effectiveness of chlorhexidine-impregnated sponges for reducing catheter-related infections of central venous catheters inserted for cancer chemotherapy. The method used was a randomized, prospective, open, controlled clinical study (three-step group sequential analysis protocol). The patients were from two high dependency units at a university hospital undergoing chemotherapy for haematological or oncological malignancies requiring central venous catheters (CVCs) expected to remain in place for at least 5 days. Six hundred and one patients with 9,731 catheterization days were studied between January 2004 and January 2006. Patients admitted for chemotherapy received chlorhexidine and silver sulfadiazine-impregnated triple-lumen CVCs under standardized conditions and were randomized to the groups receiving a chlorhexidine gluconate-impregnated wound dressing or a standard sterile dressing. Daily routine included clinical assessment of the insertion site (swelling, pain, redness), temperature, white blood count and C-reactive protein. Catheters remained in place until they were no longer needed or when a CVCrelated infection was suspected. Infection was confirmed with blood cultures via the catheter lumina and peripheral blood cultures according to the time-to-positivity method. Six hundred and one patients were included. The groups were comparable with respect to demographic and clinical data. The incidence of CVC-related infections were 11.3% (34 of 301) and 6.3% (19 of 300) in the control and chlorhexidine-impregnated wound dressing groups, respectively (p=0.016, relative risk 0.54; confidence interval 0.31-0.94). Especially, catheter-related infections at internal jugular vein insertions could be reduced (p=0.018). No adverse effects related to the intervention were observed. The use of chlorhexidine-impregnated wound dressings significantly reduced the incidence of CVC-related infections in patients receiving chemotherapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

et al. 2008

View full text Add to dashboard Cite

show abstract

“…8 In paediatric patients, two small RCTs found a reduction in catheter colonisation but not CR-BSI, and evidence of localised contact dermatitis when used for infants of very low birth weight. 12,13 We identified one further systematic review and meta-analysis, undertaken as part of a quality improvement collaborative, which synthesised the effects of the routine use of 2% chlorhexidine gluconate (CHG) impregnated sponge dressings in reducing centrally inserted CR-BSI. 14 Five studies were included in the analysis, two of the five studies were in patients in haemo/oncological intensive care units (ICU), the remaining three were in surgical and medical ICU; four of the five studies were sponsored by the manufacturer of the product.…”

Section: Choose the Right Dressing For Insertion Sites To Minimise Inmentioning

confidence: 99%

epic3: revised recommendation for intravenous catheter and catheter site care

Loveday

Wilson

Prieto

et al. 2016

Journal of Hospital Infection

View full text Add to dashboard Cite

“…Studies by Garland et al (2001); Levy et al (2005) and Onder et al (2009) specifically evaluated pediatric patients, each of which evaluated the effectiveness of chlorhexidine-impregnated discs versus no discs. Garland et al (2001) performed a prospective, randomized, controlled, multicenter study, which evaluated critically ill neonates requiring a CVC at least 48 hours (n = 705).…”

Section: Effectiveness Of Chlorhexidine-impregnated Discs In Hospitalmentioning

confidence: 99%

“…This study was unique in that the mean duration of catheterization was 17 days, meaning that the use of chlorhexidineimpregnated discs may not be effective in long-term catheterization. Levy and colleagues (Levy et al, 2005) performed a randomized controlled trial in critically ill pediatric patients (n = 145) post-cardiac surgery. This study demonstrated significant reductions in catheter colonization (14.2% reduction, p = 0.04), but no reduction in CRBSIs in the chlorhexidine-impregnated disc group (p = 1).…”

Section: Effectiveness Of Chlorhexidine-impregnated Discs In Hospitalmentioning

confidence: 99%

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Daniels

Frei²

2012

American Journal of Infectious Diseases

View full text Add to dashboard Cite

Problem statement: Healthcare-associated infections are the 5th leading cause of death in the United States. Catheter-Related Bloodstream Infections (CRBSIs) comprise 14% of all healthcareassociated infections and contribute to increased mortality and financial costs. Antimicrobialimpregnated sponge discs to be used surrounding the catheter insertion site are a newer addition to the options available for the prevention of catheter-related infections. Approach: This review critically appraises the literature regarding the utility of antimicrobial-impregnated discs. We performed a literature search using the MEDLINE (1948-November 2011) database. Only controlled clinical trials were included and the electronic database search was performed using the following MeSH and keyword search terms: ("Biopatch" or "chlorhexidine") and ("dressing" or "sponge") and ("catheter"). Results: Our search yielded eight trials. Chlorhexidine-impregnated discs are effective in preventing catheter colonization in hospitalized patients and outpatients; however, effectiveness in preventing CRBSIs may be limited to hospitalized, critically ill patients. Although many studies have evaluated the effectiveness of several pharmaceutical agents for the prevention of catheter-related infections, there are still significant gaps in the literature regarding these infections, including the effectiveness of Polyhexamethylene Biguanide (PHMB)-impregnated discs and the cost-effectiveness of PHMBimpregnated discs compared to chlorhexidine-impregnated discs. It is also unclear if antimicrobialimpregnated discs are effective in specific populations, like in outpatients, patients at high risk compared to low risk patients and patients with long-term catheters. Conclusion: Chlorhexidineimpregnated discs should be utilized for the duration of catheterization in high risk, critically ill patients and in hospitals where catheter-related infection rates are persistently high despite other preventative strategies. Futher investigation of the effectiveness of these discs in other populations and of other antimicrobial-impregnated discs is needed.

show abstract

Chlorhexidine-Impregnated Dressing for Prevention of Colonization of Central Venous Catheters in Infants and Children

Abstract: The chlorhexidine gluconate-impregnated sponge is safe and significantly reduces the rates of CVC colonization in infants and children after cardiac surgery.

Cited by 133 publications

References 27 publications

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial

epic3: revised recommendation for intravenous catheter and catheter site care

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Contact Info

Product

Resources

About