Abstract | BACKGROUND: METHODS: We conducted a real-world data study evaluating the impact of incrementally introducing chlorhexidine dressings (sponge or gel) in addition to an ongoing catheter bundle on the rates of CABSI, expressed as incidence density rates per 1000 catheter-days measured as part of a surveillance program. Poisson regression models were used to compare infection rates over time. Both dressings were used simultaneously during one of the five study periods. RESULTS: From 2006 to 2014, 18,286 patients were admitted (91,292 ICU-days and 155,242 catheter-days). We recorded 111 CABSIs. We observed a progressive but significant decrease of CABSI rates from 1.48 (95% CI 1.09-2.01) without CHG dressings to 0.69 (95% CI 0.43-1.09) and 0.23 (95% CI 0.11-0.48) episodes per 1000 catheter-days when CHG sponge and CHG gel dressings were used (p = 0.0007; p < 0.001). A non-significant lower rate of infections occurred with CHG gel compared with CHG sponge dressings. An identical low rate of allergic skin reactions (0.3/1000 device-days) was observed with both types of CHX dressings. Post-study data until 2018 confirmed a sustained decrease of infection rates over 11 years. CONCLUSIONS:
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Authors | Philippe Eggimann, Jean-Luc Pagani, Elise Dupuis-Lozeron, Bruce Ekholm Ms, Marie-Josèphe Thévenin, Christine Joseph, Jean-Pierre Revelly, Yok-Ai Que |
Journal | Intensive care medicine
(Intensive Care Med)
Vol. 45
Issue 6
Pg. 823-833
(06 2019)
ISSN: 1432-1238 [Electronic] United States |
PMID | 30997542
(Publication Type: Journal Article)
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Chemical References |
- Anti-Infective Agents, Local
- Chlorhexidine
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Topics |
- Aged
- Anti-Infective Agents, Local
(pharmacology, therapeutic use)
- Bandages
(standards)
- Catheter-Related Infections
(drug therapy, epidemiology, prevention & control)
- Central Venous Catheters
(adverse effects, microbiology, statistics & numerical data)
- Chlorhexidine
(pharmacology, therapeutic use)
- Female
- Humans
- Intensive Care Units
(organization & administration, statistics & numerical data)
- Length of Stay
(statistics & numerical data)
- Male
- Middle Aged
- Patient Care Bundles
(methods, standards)
- Prospective Studies
- Sepsis
(drug therapy, epidemiology, prevention & control)
- Simplified Acute Physiology Score
- Switzerland
(epidemiology)
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