Clinical experience of using chlorhexidine gluconate-impregnated dressings in reducing the central line-associated bloodstream infection rate at a Level 1 trauma centre

Priyam Batra; S Thomas; Jacinta Gunjyal; Purva Mathur; Babita Gupta; Chhavi Swahnney; Deepak Agarwal; Ashish Bindra; Keshav Goyal; Richa Aggarwal; Kapil Soni; Rajesh Malhotra

doi:10.4103/jpsic.jpsic_15_18

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ORIGINAL ARTICLE

Year : 2018 | Volume : 6 | Issue : 2 | Page : 59-62

Clinical experience of using chlorhexidine gluconate-impregnated dressings in reducing the central line-associated bloodstream infection rate at a Level 1 trauma centre

Priyam Batra¹, S Thomas¹, Jacinta Gunjyal¹, Purva Mathur¹, Babita Gupta², Chhavi Swahnney², Deepak Agarwal³, Ashish Bindra⁴, Keshav Goyal⁴, Richa Aggarwal⁵, Kapil Soni⁵, Rajesh Malhotra⁶
¹ Department of Lab Medicine, JPNATC, AIIMS, New Delhi, India
² Department of Anaesthesia, JPNATC, AIIMS, New Delhi, India
³ Department of Neurosurgery, JPNATC, AIIMS, New Delhi, India
⁴ Department of Neuroanaesthesia, JPNATC, AIIMS, New Delhi, India
⁵ Department of Critical and Intensive Care, JPNATC, AIIMS, New Delhi, India
⁶ Department of Orthopaedics, JPNATC, AIIMS, New Delhi, India

Correspondence Address:
Dr. Purva Mathur
Room No 211, Second Floor, Department of Laboratory Medicine, JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jpsic.jpsic_15_18

Introduction: Central venous catheters are vital in critical care which can be associated with infectious and non-infectious adverse events. Materials and Methods: This case–control study was conducted over 1 year in trauma centre of India. All patients admitted in intensive care units (ICUs) having central line inserted during the study period (November 2013–October 2014) were included as cases. Historical controls with non-antibiotic-impregnated dressings were used as controls (November 2012–October 2013). Standard central line insertion and maintenance checklist was followed. Results: A total of 2034 patients were admitted in ICUs during study period, and the central line-associated bloodstream infection (CLABSI) rate was 2.89/1000 catheter days. During the year 2012–2013, 2100 patients were admitted and CLABSI rate was 3.04/1000 catheter days. The mean central line insertion bundle compliance rate was 76.8% in 2012–2013 and 78.37% in 2013–2014. The compliance with scrubbing the access port was minimum 34% while that with change in dressing was the maximum 79%. Discussion: Since CLABSI rate reduction was not statistically significant, the use of biopatch in our setting could not be justified and its use was not found to be cost-effective. In maintenance bundle, compliance with scrubbing the hub was least only 35%. Thus, the use of effective maintenance bundle parameters could easily reduce CLABSI rate.

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