A daily topical decontamination regimen reduces catheter-related bloodstream infections in haematology patients - 31/01/18
, Harpreet Kaur a, Evangelos I. Kritsotakis b, c, Stephen D. Goode d, Aileen Nield a, David Partridge c, eSummary |
Objective |
To assess impact of a topical decontamination regimen on rates of catheter-related bloodstream infections (CRBSI) in intensively-treated haematology patients.
Methods |
A historically-controlled cohort study was used to evaluate the effect of applying chlorhexidine or Octenisan® body washes and nasal Prontoderm® ointment for 5 days around the time of Hickman line insertion on the incidence of CRBSI and infection-free catheter time. Lines inserted during a 24 month period prior to implementation of the decolonisation regimen were compared with those inserted during a 12 month period after the intervention was applied.
Results |
During the post-intervention period, 163 lines were inserted in 147 patients, compared to 303 lines in 242 patients in the pre-intervention period. CRBSI rates in treated and untreated patients respectively were 6.8 and 35.0 cases per 10,000 line-days by 21 days (p = 0.009), and 14.4 and 26.0 cases respectively per 10,000 line-days by 180 days (p = 0.025).
The incidence rate of Staphylococcus aureus CRBSI in treated and untreated patients were 0.0 and 4.6 cases per 10,000 line-days respectively (p = 0.012). Multivariable Cox regression estimated an 81% probability (95% confidence interval 74%–85%) that a treated line develops a CRBSI later than an untreated line by 21 days post-insertion.
Conclusion |
Implementation of this safe and effective topical decontamination regimen enhances routine CRBSI-prevention measures for haematology patients requiring central venous line insertion.
Le texte complet de cet article est disponible en PDF.Highlights |
• | A topical decontamination regimen was introduced for haematology patients. |
• | Incidence of catheter-related bloodstream infections reduced significantly. |
• | Infection-free catheter survival times improved. |
• | Staphylococcus aureus infections were particularly reduced. |
Keywords : Haematology, Catheter-related bloodstream infection, Decolonisation, Chlorhexidine, Prontoderm®
Plan
| Conflicts of interest: none. |
Vol 76 - N° 2
P. 132-139 - février 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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