Department of cardiothoracic surgery, Children's Hospital of Nanjing Medical University, Nanjing, 21500, Jiangsu province, China.
Surgical Outpatient Department, Children's Hospital of Nanjing Medical University, Nanjing, 21500, Jiangsu province, China.
J Health Popul Nutr. 2024 Nov 1;43(1):177. doi: 10.1186/s41043-024-00672-7.
The prevention of catheter-related bloodstream infections (CRBSI) is a critical priority in the clinical management of central venous catheters (CVCs). This meta-analysis aims to evaluate the efficacy of chlorhexidine gluconate antibacterial dressings in the context of CVC care.
A systematic literature search was performed in PubMed, Web of Science, Embase et al. databases up to May 28, 2024. The search targeted randomized controlled trials (RCTs) that investigated the impact of chlorhexidine gluconate antibacterial dressings on CVC-related outcomes. The meta-analysis was conducted using RevMan 5.3 software.
The final analysis included 14 RCTs involving a total of 8920 patients with CVCs, with participants divided into a chlorhexidine antibacterial dressing group (n = 4731) and a control group (n = 4189). The chlorhexidine dressing group demonstrated a statistically significant reduction in the incidence of CRBSI compared to the control group, with a relative risk (RR) of 0.48, 95% confidence interval (CI) 0.36-0.64, P < 0.001. The chlorhexidine dressing group also showed a significant decrease in bacterial colonization, with an RR of 0.46, 95% CI 0.38-0.55, P < 0.001. Assessment of publication bias through funnel plot asymmetry and Egger's test revealed no significant bias in the included studies (all P > 0.05).
There is a notable reduction in the incidence of CRBSI and bacterial colonization in patients with CVCs through the application of chlorhexidine gluconate dressings. Given the compelling evidence, the integration of these dressings into standard nursing care protocols for the management of CVCs is advocated.
预防导管相关血流感染（CRBSI）是中央静脉导管（CVC）临床管理的关键重点。本荟萃分析旨在评估葡萄糖酸氯己定抗菌敷料在 CVC 护理中的疗效。
我们在 PubMed、Web of Science、Embase 等数据库中进行了系统的文献检索，检索截至 2024 年 5 月 28 日。该检索旨在调查葡萄糖酸氯己定抗菌敷料对 CVC 相关结局影响的随机对照试验（RCT）。荟萃分析使用 RevMan 5.3 软件进行。
最终分析纳入了 14 项 RCT，共涉及 8920 例 CVC 患者，参与者分为氯己定抗菌敷料组（n=4731）和对照组（n=4189）。与对照组相比，氯己定敷料组的 CRBSI 发生率显著降低，相对风险（RR）为 0.48，95%置信区间（CI）为 0.36-0.64，P<0.001。氯己定敷料组的细菌定植也显著减少，RR 为 0.46，95%CI 为 0.38-0.55，P<0.001。通过漏斗图不对称和 Egger 检验评估发表偏倚，发现纳入研究无显著偏倚（均 P>0.05）。
在 CVC 患者中应用葡萄糖酸氯己定敷料可显著降低 CRBSI 和细菌定植的发生率。鉴于有强有力的证据支持，我们提倡将这些敷料纳入 CVC 管理的标准护理方案中。
