A fall in bloodstream infections followed a change to 2% chlorhexidine in 70% isopropanol for catheter connection antisepsis: a pediatric single center before/after study on a hemopoietic stem cell transplant ward.

Abstract

BACKGROUND:

Some catheter-related bloodstream infections originate from catheter connectors; therefore, improved antisepsis of these might be expected to reduce the incidence of such infections.

METHODS:

In this observational before/after study at a pediatric tertiary referral hospital, inpatients up to 16 years old undergoing hemopoietic stem cell transplants were studied. Catheter connection antisepsis was changed from 70% isopropanol alone to 2% chlorhexidine in 70% isopropanol. Numbers of catheter-related bloodstream infections before and after the change were monitored as were the numbers of catheter days experienced by patients.

RESULTS:

The infection rate before the change was 12 per 1000 catheter-days, and, following the change, this fell to 3 per 1000 catheter-days (P=.004). Similar falls followed the introduction of chlorhexidine to other wards.

CONCLUSION:

The introduction of chlorhexidine was followed by a profound, sustained fall in catheter-related infections. The results support the 2007 United Kingdom guidelines recommending 2% chlorhexidine in 70% isopropanol as a disinfectant of needleless connectors and hubs of central venous catheters.

• Authors: James S Soothill, Karen Bravery, Anne Ho, Susan Macqueen, Jane Collins, Paul Lock
• Journal: American journal of infection control (Am J Infect Control) Vol. 37 Issue 8 Pg. 626-30 (Oct 2009) ISSN: 1527-3296 [Electronic] United States
• PMID: 19616869 (Publication Type: Journal Article)

Chemical References

• Anti-Infective Agents, Local
• Drug Combinations
• 2-Propanol
• Chlorhexidine

Topics

• 2-Propanol (pharmacology)
• Anti-Infective Agents, Local (pharmacology)
• Antisepsis (methods)
• Catheter-Related Infections (epidemiology, microbiology, prevention & control)
• Catheters, Indwelling (adverse effects, microbiology)
• Child, Preschool
• Chlorhexidine (pharmacology)
• Cross Infection (epidemiology, etiology, microbiology, prevention & control)
• Drug Combinations
• Equipment Contamination (prevention & control)
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Male
• Sepsis (epidemiology, etiology, microbiology, prevention & control)
• Transplantation Conditioning