University of Pennsylvania School of Medicine, Philadelphia, USA.
Infect Control Hosp Epidemiol. 2010 Feb;31(2):171-6. doi: 10.1086/650201.
To determine blood culture contamination rates after skin antisepsis with chlorhexidine, compared with povidone-iodine.
Retrospective, quasi-experimental study.
Emergency department of a tertiary care children's hospital.
Children aged 2-36 months with peripheral blood culture results from February 2004 to June 2008. Control patients were children younger than 2 months with peripheral blood culture results.
Blood culture contamination rates were compared using segmented regression analysis of time-series data among 3 patient groups: (1) patients aged 2-36 months during the 26-month preintervention period, in which 10% povidone-iodine was used for skin antisepsis before blood culture; (2) patients aged 2-36 months during the 26-month postintervention period, in which 3% chlorhexidine gluconate was used; and (3) patients younger than 2 months not exposed to the chlorhexidine intervention (ie, the control group).
Results from 11,595 eligible blood cultures were reviewed (4,942 from the preintervention group, 4,274 from the postintervention group, and 2,379 from the control group). For children aged 2-36 months, the blood culture contamination rate decreased from 24.81 to 17.19 contaminated cultures per 1,000 cultures (P < .05) after implementation of chlorhexidine. This decrease of 7.62 contaminated cultures per 1,000 cultures (95% confidence interval, -0.781 to -15.16) represented a 30% relative decrease from the preintervention period and was sustained over the entire postintervention period. No change in contamination rate was observed in the control group (P = .337).
Skin antisepsis with chlorhexidine significantly reduces the blood culture contamination rate among young children, as compared with povidone-iodine.
比较洗必泰与聚维酮碘皮肤消毒后血培养污染率。
回顾性准实验研究。
一家三级儿童保健医院的急诊室。
2004 年 2 月至 2008 年 6 月期间年龄为 2-36 个月的外周血培养结果患者。对照组为年龄小于 2 个月的外周血培养结果患者。
采用时间序列数据分析方法比较 3 组患者的血培养污染率：（1）26 个月干预前时期的 2-36 个月龄患者，在此期间 10%聚维酮碘用于血培养前皮肤消毒；（2）26 个月干预后时期的 2-36 个月龄患者，在此期间 3%葡萄糖酸氯己定用于皮肤消毒；（3）未暴露于氯己定干预的年龄小于 2 个月的患者（即对照组）。
共回顾了 11595 份合格的血培养结果（干预前组 4942 份，干预后组 4274 份，对照组 2379 份）。对于 2-36 个月龄的儿童，在实施洗必泰后，血培养污染率从每 1000 份培养物中有 24.81 份污染培养物降至 17.19 份（P<0.05）。每 1000 份培养物减少 7.62 份污染培养物（95%置信区间，-0.781 至-15.16），与干预前时期相比相对减少 30%，并且在整个干预后时期持续存在。对照组的污染率没有变化（P=0.337）。
与聚维酮碘相比，洗必泰皮肤消毒可显著降低幼儿的血培养污染率。
