Wibaux Anne, Thota Priyaleela, Mastej Jozef, Prince Daniel L, Carty Neal, Johnson Peter
Vancive Medical Technologies, an Avery Dennison business, 20 N. Wacker Drive Suite 2240, Chicago, Illinois, 60606, United States of America.
Gibraltar Laboratories Inc., Fairfield, New Jersey, 07004, United States of America.
PLoS One. 2015 Nov 23;10(11):e0143035. doi: 10.1371/journal.pone.0143035. eCollection 2015.
Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing.
Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time.
The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested.
The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes.
已证实使用洗必泰浸渍敷料覆盖插入部位在减少导管相关血流感染（CR-BSI）方面具有临床效果。有两种市售的葡萄糖酸洗必泰（CHG）浸渍敷料，一种是聚氨酯泡沫圆盘，另一种是含有葡萄糖酸洗必泰浸渍凝胶垫的薄膜敷料。虽然两者在临床环境中均已证明有效，但高成本和静脉插入部位可视性受损这一主要缺点限制了它们的使用。现在有一种新型的、简单的在其粘合剂层中含有CHG的薄膜敷料。本研究的目的是测试这种新型敷料与CHG浸渍凝胶敷料相比的体外抗菌效果。
将临床相关挑战微生物（葡萄球菌属、革兰氏阴性杆菌、白色念珠菌）的定量等分悬液（浓度为1.0×10⁶至5.0×10⁶ cfu/样本）与新型含CHG薄膜敷料、相同的安慰剂版本（阴性对照）和市售的CHG浸渍凝胶敷料（阳性对照）接触孵育。在孵育1、3、5和7天后，使用倾注平板对存活微生物的系列稀释液进行定量，以便计算每个时间点每种微生物/敷料组合的抗菌log₁₀降低值。
在测试的所有需氧革兰氏阴性杆菌和葡萄球菌属中，新型含CHG薄膜敷料在7天内均实现了大于5.0 log₁₀的降低。截至第1天，含CHG薄膜敷料对白色念珠菌实现了大于5.0 log₁₀的降低。测试的两种敷料之间的log₁₀降低值无统计学显著差异。
发现新型含CHG薄膜敷料在临床相关微生物方面与葡萄糖酸洗必泰浸渍凝胶敷料一样有效。
