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Meta-Analysis
. 2014 Jul;42(7):1703-13.
doi: 10.1097/CCM.0000000000000319.

Chlorhexidine-impregnated dressing for prevention of catheter-related bloodstream infection: a meta-analysis*

Nasia Safdar  1 , John C O'Horo, Aiman Ghufran, Allison Bearden, Maria Eugenia Didier, Dan Chateau, Dennis G Maki
Affiliations
Meta-Analysis

Chlorhexidine-impregnated dressing for prevention of catheter-related bloodstream infection: a meta-analysis*

Nasia Safdar et al. Crit Care Med. 2014 Jul.

Abstract

Objective: To assess the efficacy of a chlorhexidine-impregnated dressing for prevention of central venous catheter-related colonization and catheter-related bloodstream infection using meta-analysis.

Data sources: Multiple computerized database searches supplemented by manual searches including relevant conference proceedings.

Study selection: Randomized controlled trials evaluating the efficacy of a chlorhexidine-impregnated dressing compared with conventional dressings for prevention of catheter colonization and catheter-related bloodstream infection.

Data extraction: Data were extracted on patient and catheter characteristics and outcomes.

Data synthesis: Nine randomized controlled trials met the inclusion criteria. Use of a chlorhexidine-impregnated dressing resulted in a reduced prevalence of catheter-related bloodstream infection (random effects relative risk, 0.60; 95% CI, 0.41-0.88, p = 0.009). The prevalence of catheter colonization was also markedly reduced in the chlorhexidine-impregnated dressing group (random effects relative risk, 0.52; 95% CI, 0.43-0.64; p < 0.001). There was significant benefit for prevention of catheter colonization and catheter-related bloodstream infection, including arterial catheters used for hemodynamic monitoring. Other than in low birth weight infants, adverse effects were rare and minor.

Conclusions: Our analysis shows that a chlorhexidine-impregnated dressing is beneficial in preventing catheter colonization and, more importantly, catheter-related bloodstream infection and warrants routine use in patients at high risk of catheter-related bloodstream infection and central venous catheter or arterial catheter colonization.

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Figures

Figure 1
Figure 1
Literature search and selection of studies
Figure 2
Figure 2
Relative risk of catheter colonization with chlorhexidine-impregnated dressing and comparator using a random effects model. I will redo the charts to provide the correct reference number after the name for each when we have the rest edited as the numbers may shift
Figure 3
Figure 3
Relative risk of CRBSI with chlorhexidine-impregnated dressing and comparator using a random effects model.
Figure 4
Figure 4
Funnel plot to evaluate for publication bias for colonization (left) and CRBSI (right). Publication bias is not evident.
See this image and copyright information in PMC

Comment in

References

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