Comparison of alcoholic chlorhexidine and povidone–iodine cutaneous antiseptics for the prevention of central venous catheter-related infection: a cohort and quasi-experimental multicenter study

Abstract

NCT01479153.

Management and Prevention of Central Venous Catheter-Related Infections in the ICU

“…In patients without contraindications (e.g., chlorhexidine allergy), a sterile 2% (w/v) chlorhexidine gluconate (CHG) solution should be used to decontaminate the skin prior to the insertion of a vascular catheter and neither aqueous nor alcoholic povidone-iodine (PVI) should be used as a first-line agent for skin decontamination. 19,[51][52][53] The CHG superiority is probably due to its rapid bactericidal activity. The majority of these studies were conducted using 2% alcoholic CHG. Interestingly, one prospective cohort study found no difference of catheter colonization of CR-BSI between 0.5% alcoholic chlorhexidine and 2% aqueous chlorhexidine.…”

“…The majority of these studies were conducted using 2% alcoholic CHG. Interestingly, one prospective cohort study found no difference of catheter colonization of CR-BSI between 0.5% alcoholic chlorhexidine and 2% aqueous chlorhexidine. 54 In contrast, another observational study found a similar risk for catheter-related infections between alcoholic CHG <1% and alcoholic PVI, suggesting less benefit using lower concentration of CHG. 53 The potential benefit of the 2% alcoholic CHG compared with 0.5% alcoholic CHG has been demonstrated only in vitro. 55 Given the widespread use of CHG in medicine, the development of CHG resistance and especially crossresistance to clinically relevant antibiotics has raised concerns.…”

Efecto del uso de protectores puerto desinfectantes para la disminución de las bacteriemias asociadas a catéteres venosos centrales

“…Se estima que entre un 7% a un 10 % de las personas que se encuentran hospitalizadas llegan a requerirlos 3,4 . Por tanto, una mayor demanda en su uso ha significado un incremento en el riesgo de desarrollar Bacteriemias Asociadas al Catéter Venoso Central (BACVC) 5 . En este sentido, un cuidado básico asociado con su prevención es la desinfección, tanto del sitio de inserción antes de colocar el catéter, como de los puertos de acceso mientras se use el dispositivo 6 .…”

Povidone‐iodine lowers the incidence of catheter‐associated bloodstream infection

“…The main risk factors associated with the development of catheter‐associated infections include frequent manipulation of the CV catheter, longer duration of catheterization, double‐lumen catheters, and neutropenia . Trials conducted to reduce the incidence of such infections show that using chlorhexidine and povidone‐iodine to disinfect the skin at the catheter insertion site does not significantly alter the frequency of catheter‐associated bloodstream infection (CABSI) . The latest guidelines issued by the US Centers for Disease Control and Prevention (CDC) recommend ensuring sterile access to CV catheters by scrubbing the access port with appropriate antiseptics, such as chlorhexidine, povidone‐iodine, or 70% alcohol, and accessing the port with sterile devices .…”

“…2,3 Trials conducted to reduce the incidence of such infections show that using chlorhexidine and povidone-iodine to disinfect the skin at the catheter insertion site does not significantly alter the frequency of catheterassociated bloodstream infection (CABSI). 2,[4][5][6] The latest guidelines issued by the US Centers for Disease Control and Prevention (CDC) recommend ensuring sterile access to CV catheters by scrubbing the access port with appropriate antiseptics, such as chlorhexidine, povidone-iodine, or 70% alcohol, and accessing the port with sterile devices. 7 The optimal method for accessing, however, the ports has not been established; no prospective study has addressed this issue.…”