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Randomized Controlled Trial
. 2022 Jan;64(1):e15011.
doi: 10.1111/ped.15011.

Comparison of chlorhexidine impregnated dressing and standard dressing for the prevention of central-line associated blood stream infection and colonization in critically ill pediatric patients: A randomized controlled trial

Muhterem Duyu  1 , Zeynep Karakaya  2 , Pinar Yazici  3 , Senanur Yavuz  4 , Nihal Meryem Yersel  4 , Melike Orkide Tascilar  5 , Nazim Firat  4 , Ozlem Bozkurt  4 , Yasemin Caglar Mocan  6
Affiliations
Randomized Controlled Trial

Comparison of chlorhexidine impregnated dressing and standard dressing for the prevention of central-line associated blood stream infection and colonization in critically ill pediatric patients: A randomized controlled trial

Muhterem Duyu et al. Pediatr Int. 2022 Jan.

Abstract

Background: The aim of this study was to compare chlorhexidine gluconate (CHG)-impregnated dressing and standard dressing with respect to the frequency of central-line-associated bloodstream infection (CLABSI), catheter-related bloodstream infection, primary bloodstream infection, and catheter colonization in critically ill pediatric patients with short-term central venous catheters.

Methods: Children who were admitted to the pediatric intensive care unit of a tertiary institution between May 2018 and December 2019 and received placement of a short-term central venous catheter were included in this single-center randomized controlled trial. Patients were grouped according to the type of catheter fixation applied.

Results: A total of 307 patients (151 CHG-impregnated dressing, 156 standard dressing), with 307 catheters (amounting to a collective total of 4,993 catheter days), were included in the study. The CHG-impregnated dressing did not significantly decrease the incidence of CLABSI (6.36 vs 7.59 per 1,000 catheter days; hazard ratio (HR): 0.93, P = 0.76), catheter related bloodstream infection (3.82 vs 4.18 per 1,000 catheter days; HR: 0.98; P = 0.98), and primary bloodstream infection (2.54 vs 3.42 catheter days; HR: 0.79; P = 0.67). The CHG-impregnated dressing significantly decreased the incidence of catheter colonization (3.82 vs 7.59 per 1,000 catheter days; HR: 0.40; P = 0.04). In both groups, the most frequent microorganisms isolated in CLABSI or catheter colonization were Gram-positive bacteria (the majority were coagulase-negative staphylococci).

Conclusions: The use of CHG-impregnated dressing does not decrease CLABSI incidence in critically ill pediatric patients but it significantly reduced catheter colonization. Coagulase-negative staphylococci were the most common microorganisms causing CLABSI or catheter colonization.

Keywords: central line associated bloodstream infection; central venous catheter; chlorhexidine dressing; colonization; pediatric critical care.

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References

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