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异丙醇在预防血培养污染方面与氯己定一样有效。

Isopropyl alcohol is as efficient as chlorhexidine to prevent contamination of blood cultures.

作者信息

Martínez Jovanna, Macías Juan H, Arreguín Virginia, Álvarez Jose A, Macías Alejandro E, Mosqueda-Gómez Juan L

机构信息

Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, Mexico.

Universidad de Guanajuato, León, Guanajuato, Mexico.

出版信息

Am J Infect Control. 2017 Apr 1;45(4):350-353. doi: 10.1016/j.ajic.2016.11.027. Epub 2017 Jan 12.

Abstract

BACKGROUND

False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required.

METHODS

Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals. Patients aged 16 years or older with suspected bloodstream infection who were allocated in the emergency room, internal medicine ward, or intensive care unit were included.

RESULTS

Five of 563 (0.9%) blood cultures from the isopropyl arm and 10 of 539 (1.9%) from the chlorhexidine arm were contaminated. No significant differences were observed among the rate of contamination (χ=1.27; P = .3) or the relative risk of contamination (relative risk = 2.09; 95% confidence interval, 0.72-6.07; P = .2).

CONCLUSIONS

The rates of blood contamination were not different when isopropyl alcohol and chlorhexidine were compared. Isopropyl alcohol could be used for skin antisepsis before blood collection.

摘要

背景

血培养假阳性会导致不必要的风险和抗生素的滥用;为降低假阳性率,确定是否需要使用具有长效作用的防腐剂将很有帮助。

方法

在两家医院进行疗效的临床研究(双盲和随机),比较使用70%异丙醇或2%葡萄糖酸氯己定的70%异丙醇溶液进行皮肤消毒时血培养污染率。纳入年龄在16岁及以上、在急诊室、内科病房或重症监护病房被分配的疑似血流感染患者。

结果

异丙醇组563份血培养中有5份(0.9%)被污染,氯己定组539份中有10份(1.9%)被污染。污染率(χ=1.27;P = 0.3)或污染相对风险(相对风险=2.09;95%置信区间,0.72 - 6.07;P = 0.2)之间未观察到显著差异。

结论

比较异丙醇和氯己定后,血污染率没有差异。异丙醇可用于采血前的皮肤消毒。

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