ArticleIntensive care medicine2019
Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years.
Article in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 53 citations in OpenAlex.
- Dermatological Safety of Chlorhexidine-Impregnated Dressings in Paediatric Intensive Care: A Randomised Clinical Trial.Nursing in critical care · 2026Trial
- An international randomised controlled trial of a novel antimicrobial dressing for peripheral intravenous catheters (ProP trial).Antimicrobial resistance and infection control · 2026Trial
- Prevention of arterial catheter-related bloodstream infections: current evidence and future directions.Critical care (London, England) · 2026Review
- Minimizing hospital acquired intensive care unit infections: A focus on prevention.World journal of critical care medicine · 2026Review
- Impact of intensified prevention measures on rates of hospital-acquired bloodstream infection in medical-surgical intensive care units, Israel, 2011 to 2019.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- Catheter dressings.Intensive care medicine · 2022Article
- Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies.Intensive & critical care nursing · 2022Article
- Vascular access for renal replacement therapy among 459 critically ill patients: a pragmatic analysis of the randomized AKIKI trial.Annals of intensive care · 2021Article
- Review
- Chlorhexidine-dress related contact dermatitis-the precautionary principle is no more relevant!Critical care (London, England) · 2020Article
- Update in COVID-19 in the intensive care unit from the 2020 HELLENIC Athens International symposium.Anaesthesia, critical care & pain medicine · 2020Review
- [The Incidences of Catheter Colonization and Central Line-Associated Bloodstream Infection According to Tegaderm vs. Chlorhexidine Gluconate (CHG)-Tegaderm Dressing].Journal of Korean Academy of Nursing · 2020Article
- Chlorhexidine-impregnated sponge versus chlorhexidine gel dressing for short-term intravascular catheters: which one is better?Critical care (London, England) · 2020Article
- Focus on infection.Intensive care medicine · 2020Article
- ECLS-associated infections in adults: what we know and what we don't yet know.Intensive care medicine · 2020Review
- Catheter-associated bloodstream infection rates: how low can you go?Intensive care medicine · 2019Article
- Comparative Effectiveness of 2 Chlorhexidine Gluconate-Containing Dressings in Reducing Central Line-Associated Bloodstream Infections, Hospital Stay, and Costs.Inquiry : a journal of medical care organization, provision and financingArticle
- Nationwide Burden and Hospital Costs of Surgical Site Complications in France: A Retrospective Analysis of the French National PMSI Administrative Database.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProspective randomized controlled studies have demonstrated that addition of chlorhexidine (CHG) dressings reduces the rate of catheter (central venous and arterial)-associated bloodstream infections (CABSIs). However, studies confirming their impact in a real-world setting are lacking.
methodsWe 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.
resultsFrom 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.
conclusionsThe addition of chlorhexidine dressings to all CVC and arterial lines to an ongoing catheter bundle was associated with a sustained 11-year reduction of all catheter-associated bloodstream infections. This large real-world data study further supports the current recommendations for the systematic use of CHG dressings on all catheters of ICU patients.
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