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评估用于血培养采集准备的皮肤消毒的氯己定醇(2%葡萄糖酸氯己定在70%异丙醇中)。

Evaluation of ChloraPrep (2% chlorhexidine gluconate in 70% isopropyl alcohol) for skin antisepsis in preparation for blood culture collection.

作者信息

McLellan E, Townsend R, Parsons H K

机构信息

Department of Microbiology, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, United Kingdom.

出版信息

J Infect. 2008 Dec;57(6):459-63. doi: 10.1016/j.jinf.2008.08.012. Epub 2008 Oct 10.

Abstract

OBJECTIVES

Blood culture contamination is a significant adverse event. This study evaluated whether using ChloraPrep (2% alcoholic chlorhexidine) instead of 70% isopropyl alcohol wipes reduced contamination rates on two Medical Assessment Units (MAU1 and MAU2).

METHODS

ChloraPrep was introduced for 2 to 3-month intervention periods, initially on MAU1 and MAU2 and subsequently on MAU1 only. Contamination rates were compared with a matched time period in the preceding year and the three month period before ChloraPrep introduction. Education regarding venepucture technique was delivered.

RESULTS

Contamination rates for the time matched pre-intervention period were 17.3% (51/295), MAU1 and 13.5% (31/230), MAU2. During the initial period of ChloraPrep use, rates declined (MAU1; 6.6% [P<0.001], MAU2; 8.5% [P=0.11] both Fisher's Exact Test). However, rates had already started to fall prior to ChloraPrep introduction. There was a non-significant difference between contamination rates in the comparator period immediately prior to ChloraPrep introduction and rates during the first intervention period (MAU1 and MAU2; P>0.05). During the second intervention period, absence of ChloraPrep on MAU2 did not significantly affect contamination (P=0.41) on this ward.

CONCLUSIONS

ChloraPrep skin antisepsis did not give a significant reduction in blood culture contamination, but education may have led to the trend to lower contamination.

摘要

目的

血培养污染是一项重大不良事件。本研究评估使用氯己定醇(2%酒精洗必泰)而非70%异丙醇擦拭巾是否能降低两个医疗评估单元(MAU1和MAU2)的污染率。

方法

氯己定醇被引入进行2至3个月的干预期,最初在MAU1和MAU2,随后仅在MAU1。将污染率与前一年的匹配时间段以及引入氯己定醇前的三个月时间段进行比较。提供了关于静脉穿刺技术的教育。

结果

时间匹配的干预前期,MAU1的污染率为17.3%(51/295),MAU2为13.5%(31/230)。在使用氯己定醇的初始阶段,污染率下降(MAU1;6.6%[P<0.001],MAU2;8.5%[P = 0.11],均为Fisher精确检验)。然而,在引入氯己定醇之前污染率就已经开始下降。在紧接引入氯己定醇之前的对照期污染率与第一个干预期的污染率之间无显著差异(MAU对MAU2;P>0.05)。在第二个干预期,MAU2未使用氯己定醇对该病房的污染无显著影响(P = 0.41)。

结论

氯己定醇皮肤消毒并未显著降低血培养污染,但教育可能导致了污染率降低的趋势。

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