Background: Prospective randomized controlled studies have demonstrated that addition of chlorhexidine (CHG) dressings reduces the rate of catheter (central venous and arterial)-associated bloodstream infections (CABSIs). However, studies confirming their impact in a real-world setting are lacking.
Methods: We conducted a real-world data study evaluating the impact of incrementally introducing chlorhexidine dressings (sponge or gel) in addition to an ongoing catheter bundle on the rates of CABSI, expressed as incidence density rates per 1000 catheter-days measured as part of a surveillance program. Poisson regression models were used to compare infection rates over time. Both dressings were used simultaneously during one of the five study periods.
Results: From 2006 to 2014, 18,286 patients were admitted (91,292 ICU-days and 155,242 catheter-days). We recorded 111 CABSIs. We observed a progressive but significant decrease of CABSI rates from 1.48 (95% CI 1.09-2.01) without CHG dressings to 0.69 (95% CI 0.43-1.09) and 0.23 (95% CI 0.11-0.48) episodes per 1000 catheter-days when CHG sponge and CHG gel dressings were used (p = 0.0007; p < 0.001). A non-significant lower rate of infections occurred with CHG gel compared with CHG sponge dressings. An identical low rate of allergic skin reactions (0.3/1000 device-days) was observed with both types of CHX dressings. Post-study data until 2018 confirmed a sustained decrease of infection rates over 11 years.
Conclusions: The addition of chlorhexidine dressings to all CVC and arterial lines to an ongoing catheter bundle was associated with a sustained 11-year reduction of all catheter-associated bloodstream infections. This large real-world data study further supports the current recommendations for the systematic use of CHG dressings on all catheters of ICU patients.
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http://dx.doi.org/10.1007/s00134-019-05617-x | DOI Listing |
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Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité - Medical Heart Center of Charité and German Heart Institute Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
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Nat Microbiol
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Section of General Surgery, Department of Surgery, University of Chicago, Chicago, IL, USA.
Sepsis is a major cause of morbidity and mortality, but our understanding of the mechanisms underlying survival or susceptibility is limited. Here, as pathogens often subvert host defence mechanisms, we hypothesized that this might influence the outcome of sepsis. We used microbiota analysis, faecal microbiota transplantation, antibiotic treatment and caecal metabolite analysis to show that gut-microbiota-derived tryptophan metabolites including indoles increased host survival in a mouse model of Serratia marcescens sepsis.
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March 2025
Beijing Minhai Biotechnology Co. Ltd, Beijing 102600, China. Electronic address:
Streptococcus pneumoniae is a major pathogen of bacterial pneumonia, meningitis, sepsis, and otitis media. The pathogenicity of this bacterium is largely attributed to its polysaccharide capsule, a protective layer around bacterial cell that enables bacteria to resist against host defense. Capsular polysaccharides (CPSs) of S.
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Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA.
Int J Surg Case Rep
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Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan.
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