Karpanen Tarja J, Casey Anna L, Whitehouse Tony, Nightingale Peter, Das Ira, Elliott Thomas S J
Department of Clinical Microbiology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Birmingham, UK.
Department of Anaesthetics and Intensive Care, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Birmingham, UK.
Am J Infect Control. 2016 Jan 1;44(1):54-60. doi: 10.1016/j.ajic.2015.08.022. Epub 2015 Oct 9.
A major source of microbial colonization of short-term central venous catheters (CVC) is the patients' endogenous skin microorganisms located at the CVC insertion site. The aim of this study was to determine if a transparent film dressing incorporating a 2% (weight/weight) chlorhexidine gluconate (CHG) gel decreases CVC and insertion site microbial colonization compared with a nonantimicrobial dressing in adult patients in critical care.
On CVC removal, samples for microbiological investigation were taken from both the skin surrounding the CVC insertion site and also from sutures securing the CVC. The sutures and intradermal and tip sections of the CVC were also collected for microbiological investigation. Microorganisms recovered from the samples were subsequently tested for susceptibility to CHG.
There was a significant reduction in the number of microorganisms recovered from the CVC insertion site, suture site, sutures, and catheter surface in the CHG dressing group (n = 136) compared with the nonantimicrobial dressing group (n = 137). There was no significant difference in susceptibility to CHG between the microorganisms isolated from the CHG and standard dressing study patients.
A film dressing incorporating a CHG gel pad significantly reduced the number of microorganisms at the CVC insertion and suture sites with concomitant reduced catheter colonization.
短期中心静脉导管(CVC)微生物定植的一个主要来源是位于CVC插入部位的患者内源性皮肤微生物。本研究的目的是确定与非抗菌敷料相比,含有2%(重量/重量)葡萄糖酸氯己定(CHG)凝胶的透明薄膜敷料是否能减少重症监护成年患者的CVC及插入部位的微生物定植。
在拔除CVC时,从CVC插入部位周围的皮肤以及固定CVC的缝线处采集微生物学调查样本。还收集CVC的缝线、真皮内段和尖端部分进行微生物学调查。随后对从样本中分离出的微生物进行CHG敏感性测试。
与非抗菌敷料组(n = 137)相比,CHG敷料组(n = 136)从CVC插入部位、缝线部位、缝线和导管表面回收的微生物数量显著减少。从CHG敷料组和标准敷料组研究患者中分离出的微生物对CHG的敏感性没有显著差异。
含有CHG凝胶垫的薄膜敷料显著减少了CVC插入部位和缝线部位的微生物数量,同时减少了导管定植。