دورية أكاديمية
Randomized Controlled Trial of Chlorhexidine Dressing and Highly Adhesive Dressing for Preventing Catheter-related Infections in Critically Ill Adults
| العنوان: | Randomized Controlled Trial of Chlorhexidine Dressing and Highly Adhesive Dressing for Preventing Catheter-related Infections in Critically Ill Adults |
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| المؤلفون: | Timsit, Jean-François, Mimoz, Olivier, Mourvillier, Bruno, Souweine, Bertrand, Garrouste-Orgeas, Maïté, Alfandari, Serge, Plantefeve, Gaetan, Bronchard, Régis, Troché, Gilles, Gauzit, Rémy, Antona, Marion, Canet, Emmanuel, Bohe, Julien, Lepape, Alain, Vésin, Aurélien, Arrault, Xavier, Schwebel, Carole, Adrie, Christophe, Zahar, Jean-Ralph, Ruckly, Stephane, Tournegros, Caroline, Lucet, Jean-Christophe |
| المساهمون: | Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anesthésie réanimation Poitiers, Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ), Pharmacologie des anti-infectieux (PHAR Poitiers ), Université de Poitiers = University of Poitiers (UP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de réanimation médicale et infectieuse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS), Service des maladies infectieuses, Centre hospitalier Argenteuil (CH Argenteuil), Centre Hospitalier de Versailles André Mignot (CHV), Service d'anesthésie-réanimation Hôtel-Dieu, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Soins Intensifs CHU Cochin, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin AP-HP, Service de Médecine Intensive CHU Nantes, Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes), Service de Réanimation Médicale Sud, Centre Hospitalier Lyon Sud CHU - HCL (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Laboratoire des pathogènes émergents -- Emerging Pathogens Laboratory (LPE-Fondation Mérieux), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Bichat - Claude Bernard, Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, General ICU, Hôpital Delafontaine, Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes 2016-2019 (UGA 2016-2019 ) |
| المصدر: | ISSN: 1073-449X. |
| بيانات النشر: | HAL CCSD American Thoracic Society |
| سنة النشر: | 2012 |
| المجموعة: | HAL Lyon 1 (University Claude Bernard Lyon 1) |
| مصطلحات موضوعية: | [SDV]Life Sciences [q-bio], [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences |
| الوصف: | International audience ; Most vascular catheter-related infections (CRIs) occur extraluminally in patients in the intensive care unit (ICU). Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates.OBJECTIVES: To determine if chlorhexidine-impregnated and strongly adherent dressings decrease catheter colonization and CRI rates.METHODS: In a 2:1:1 assessor-masked randomized trial in patients with vascular catheters inserted for an expected duration of 48 hours or more in 12 French ICUs, we compared chlorhexidine dressings, highly adhesive dressings, and standard dressings from May 2010 to July 2011. Coprimary endpoints were major CRI with or without catheter-related bloodstream infection (CR-BSI) with chlorhexidine versus nonchlorhexidine dressings and catheter colonization rate with highly adhesive nonchlorhexidine versus standard nonchlorhexidine dressings. Catheter-colonization, CR-BSIs, and skin reactions were secondary endpoints.MEASUREMENTS AND MAIN RESULTS: A total of 1,879 patients (4,163 catheters and 34,339 catheter-days) were evaluated. With chlorhexidine dressings, the major-CRI rate was 67% lower (0.7 per 1,000 vs. 2.1 per 1,000 catheter-days; hazard ratio [HR], 0.328; 95% confidence interval [CI], 0.174-0.619; P = 0.0006) and the CR-BSI rate 60% lower (0.5 per 1,000 vs. 1.3 per 1,000 catheter-days; HR, 0.402; 95% CI, 0.186-0.868; P = 0.02) than with nonchlorhexidine dressings; decreases were noted in catheter colonization and skin colonization rates at catheter removal. The contact dermatitis rate was 1.1% with and 0.29% without chlorhexidine. Highly adhesive dressings decreased the detachment rate to 64.3% versus 71.9% (P < 0.0001) and the number of dressings per catheter to two (one to four) versus three (one to five) (P < 0.0001) but increased skin colonization (P < 0.0001) and catheter colonization (HR, 1.650; 95% CI, 1.21-2.26; P = 0.0016) without influencing CRI or CR-BSI rates.CONCLUSIONS: A large randomized trial demonstrated that ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/23043083; hal-02474310; https://hal.science/hal-02474310Test; PUBMED: 23043083 |
| DOI: | 10.1164/rccm.201206-1038OC |
| الإتاحة: | https://doi.org/10.1164/rccm.201206-1038OCTest https://hal.science/hal-02474310Test |
| رقم الانضمام: | edsbas.785CDFCE |
| قاعدة البيانات: | BASE |
| DOI: | 10.1164/rccm.201206-1038OC |
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