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Critical Care Medicine:
doi: 10.1097/CCM.0000000000000319
Review Article

Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis*

Safdar, Nasia MD, PhD1,2; O’Horo, John C. MD3; Ghufran, Aiman MD2; Bearden, Allison MD, MPH2; Didier, Maria Eugenia MD2; Chateau, Dan PhD4; Maki, Dennis G. MD2

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Abstract

Objective: To assess the efficacy of a chlorhexidine-impregnated dressing for prevention of central venous catheter–related colonization and catheter-related bloodstream infection using meta-analysis.

Data Sources: Multiple computerized database searches supplemented by manual searches including relevant conference proceedings.

Study Selection: Randomized controlled trials evaluating the efficacy of a chlorhexidine-impregnated dressing compared with conventional dressings for prevention of catheter colonization and catheter-related bloodstream infection.

Data Extraction: Data were extracted on patient and catheter characteristics and outcomes.

Data Synthesis: Nine randomized controlled trials met the inclusion criteria. Use of a chlorhexidine-impregnated dressing resulted in a reduced prevalence of catheter-related bloodstream infection (random effects relative risk, 0.60; 95% CI, 0.41–0.88, p = 0.009). The prevalence of catheter colonization was also markedly reduced in the chlorhexidine-impregnated dressing group (random effects relative risk, 0.52; 95% CI, 0.43–0.64; p < 0.001). There was significant benefit for prevention of catheter colonization and catheter-related bloodstream infection, including arterial catheters used for hemodynamic monitoring. Other than in low birth weight infants, adverse effects were rare and minor.

Conclusions: Our analysis shows that a chlorhexidine-impregnated dressing is beneficial in preventing catheter colonization and, more importantly, catheter-related bloodstream infection and warrants routine use in patients at high risk of catheter-related bloodstream infection and central venous catheter or arterial catheter colonization.

© 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

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