Neurosurgery Blog: Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis*

Wednesday, June 25, 2014

Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis*

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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.

Original Article: http://journals.lww.com/ccmjournal/Fulltext/2014/07000/Chlorhexidine_Impregnated_Dressing_for_Prevention.14.aspx