The efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in reducing blood culture contamination in pediatric patients.

BACKGROUND

Blood culture is the gold standard for diagnosis of septicemia. However; false-positive blood cultures are associated with increased health care costs due to unnecessary treatment.

OBJECTIVE

To evaluate the efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in reducing blood culture contamination inpediatricpatients.

MATERIAL AND METHOD

This is a prospective study of pediatric patients who were admitted at a tertiary-care hospital. Pediatric patients who neededpercutaneous blood cultures were recruitedfrom two general pediatric wards and the pediatric intensive care unit. The authors used 10% povidone iodine as an antiseptic in odd months and 2% chlorhexidine gluconate in 70% alcohol as an antiseptic in even months in obtaining the blood culture samples.

RESULTS

There were 1,269 blood culture specimens taken from 821 patients. 654 specimens used 10%povidone iodine as an antiseptic and 619 specimens used 2% chlorhexidine gluconate in 70% alcohol as an antiseptic. The 10% povidone iodine group and the 2% chlorhexidine gluconate in 70% alcohol group had the risk of blood culture contamination of 3.21% (95%CI: 2.00%-4.87%) and 2.28% (95% CI: 1.25%-3.79%) respectively. The risk difference ofblood culture contamination was 0.93% (95% confidence interval: 0. 86-2.72%) with p = 0.31. The most common contamination organism was Coagulase negative staphylococci (68.57%). No adverse skin reactions were observed in both antiseptic solutions groups.

CONCLUSION

Use of2% chlorhexidine gluconate in 70% alcohol as an antiseptic seems to reduce the risk of blood culture contamination compared to use of 10% povidone iodine. In addition, neither of the antiseptic solutions resulted in adverse skin reactions.