Hygiene and Epidemiology Unit, CH Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
J Infect Public Health. 2012 Mar;5(1):35-42. doi: 10.1016/j.jiph.2011.10.007. Epub 2011 Dec 6.
To make a field comparison of the effectiveness, ease of use, and cost of a chlorhexidine antiseptic solution (CBA) and an alcohol-based povidone-iodine solution (PVP-IA) for the prevention of central venous catheter (CVC)-related infections in an intensive care unit, with the aim of identifying the superior antisepsis agent.
We measured the CVC colonization and infection incidence for PVP-IA (Betadine alcoolique(®)) and for CBA (Biseptine(®)) during two successive 1-year periods of routine surveillance (REA RAISIN network). A questionnaire on the ease of CBA use was administered. Consumption data were obtained from the hospital pharmacy.
The study included 806 CVC (CBA period: 371). Upon switching from PVP-IA to CBA, we recorded a significant reduction in colonization incidence/100 catheter days (1.12 vs. 1.55, p=0.041), nonsignificant differences concerning CVC-related infection incidence/100 catheter days (0.28 vs. 0.26, p=0.426), and a nonsignificant reduction in CVC-related bacteremia/100 catheter days (0.14 vs. 0.30, p=0.052). PVP-IA users were at significantly higher risk of CVC colonization or infection based on a multivariate Cox model analysis (relative risk [95% CI]: 1.48 [1.01-2.15], p=0.043). The main drawbacks of CBA use were its low cleansing activity and its colorless solution. No cost advantage was found.
Our field study revealed no major clinical advantage of CBA use in CVC infection and no cost advantage in addition to limited ease of use.
在重症监护病房中进行现场比较，以评估洗必泰抗菌溶液（CBA）和聚维酮碘酒精溶液（PVP-IA）在预防中心静脉导管（CVC）相关感染方面的有效性、易用性和成本，以确定哪种消毒剂更优越。
我们在连续两个为期 1 年的常规监测（REA RAISIN 网络）期间，测量了 PVP-IA（Betadine alcoolique(®)）和 CBA（Biseptine(®)）的 CVC 定植和感染发生率。我们还对 CBA 使用的易用性进行了问卷调查，并从医院药房获得了消耗数据。
本研究共纳入 806 例 CVC（CBA 组：371 例）。从 PVP-IA 切换到 CBA 后，我们记录到定植发生率/100 导管日显著降低（1.12 比 1.55，p=0.041），CVC 相关感染发生率/100 导管日无显著差异（0.28 比 0.26，p=0.426），CVC 相关菌血症/100 导管日也略有降低（0.14 比 0.30，p=0.052）。多变量 Cox 模型分析显示，PVP-IA 使用者的 CVC 定植或感染风险显著更高（相对风险[95%置信区间]：1.48[1.01-2.15]，p=0.043）。CBA 使用的主要缺点是其清洁活性低和溶液无色。未发现成本优势。
我们的现场研究未发现 CBA 在 CVC 感染方面有明显的临床优势，也未发现除了使用方便性有限外还有成本优势。
