Deng Aiping, Xiong Fangli, Ren Qiuping
West China School of Nursing, Sichuan University, Chengdu, China.
West China Hospital, Sichuan University, Chengdu, China.
Sci Rep. 2025 Mar 27;15(1):10657. doi: 10.1038/s41598-025-92476-w.
Catheter-related infections pose a significant risk to critically ill patients, making it crucial to select an appropriate sterilization solution. However, there is currently no consensus on the use of chlorhexidine-containing solutions or povidone-iodine (PVI) and the auxiliary ingredients in solutions. Meta-analysis. PubMed, EMBASE, OVID, Web of Science, and Cochrane Library databases. Two reviewers independently performed study screening and data extraction and used the Cochrane risk-of-bias tool 2.0 (RoB 2.0) for quality assessment. We included 10 fully published RCTs with 12 pairs of comparisons, which included a total of 9,689 catheters. The analysis revealed that chlorhexidine gluconate (CHG)-containing solutions were significantly more effective than PVI in preventing CRBSI (RR = 0.460, 95% CI 0.323-0.654, P < 0.001), catheter-related sepsis (RR = 0.419, 95% CI 0.206-0.853, P = 0.016), and catheter colonization (RR = 0.409, 95% CI 0.266-0.630, P < 0.001). Further subgroup analysis demonstrated that, regardless of the concentration of CHG (≤ 1% or > 1%), it was superior to PVI in preventing CRBSI and catheter colonization (RR = 0.271 ~ 0.585, 95% CI 0.110 ~ 0.400‒0.590‒0.926). CHG-alcohol is most effective at preventing catheter-related infections, especially those caused by 70% alcohol. Compared to PVI, CHG-70% alcohol is the most effective disinfectant for preventing catheter-related infections, as it combines the rapid disinfection and evaporation properties of alcohol with the prolonged antimicrobial effects of chlorhexidine.PROSPERO registration number: CRD42024507163.
导管相关感染对重症患者构成重大风险，因此选择合适的消毒溶液至关重要。然而，目前对于含氯己定溶液或聚维酮碘（PVI）及其溶液中的辅助成分的使用尚无共识。荟萃分析。检索了PubMed、EMBASE、OVID、Web of Science和Cochrane图书馆数据库。两名评价员独立进行研究筛选和数据提取，并使用Cochrane偏倚风险工具2.0（RoB 2.0）进行质量评估。我们纳入了10项完全发表的随机对照试验，包含12组比较，共涉及9689根导管。分析显示，含葡萄糖酸氯己定（CHG）的溶液在预防中心静脉导管相关血流感染（CRBSI）（RR = 0.460，95%可信区间0.323 - 0.654，P < 0.001）、导管相关败血症（RR = 0.419，95%可信区间0.206 - 0.853，P = 0.016）和导管定植（RR = 0.409，95%可信区间0.266 - 0.630，P < 0.001）方面显著优于PVI。进一步的亚组分析表明，无论CHG浓度（≤1%或>1%）如何，其在预防CRBSI和导管定植方面均优于PVI（RR = 0.271至0.585，95%可信区间0.110至0.400 - 0.590至0.926）。CHG - 酒精在预防导管相关感染方面最有效，尤其是由70%酒精引起的感染。与PVI相比，CHG - 70%酒精是预防导管相关感染最有效的消毒剂，因为它结合了酒精的快速消毒和挥发特性以及氯己定的长效抗菌作用。PROSPERO注册号：CRD42024507163。
