dc.contributor.author | Webster, J | |
dc.contributor.author | Larsen, E | |
dc.contributor.author | Marsh, N | |
dc.contributor.author | Choudhury, A | |
dc.contributor.author | Harris, P | |
dc.contributor.author | Rickard, CM | |
dc.date.accessioned | 2017-08-29T23:37:47Z | |
dc.date.available | 2017-08-29T23:37:47Z | |
dc.date.issued | 2017 | |
dc.identifier.issn | 0195-6701 | |
dc.identifier.doi | 10.1016/j.jhin.2017.04.009 | |
dc.identifier.uri | http://hdl.handle.net/10072/345188 | |
dc.description.abstract | Background: A number of antimicrobial-impregnated discs to prevent central-lineassociated
bloodstream infection (CLABSI) are marketed but it is unclear which disc is
most effective.
Aim: To investigate the feasibility and safety of comparing two antimicrobial-impregnated
discs to prevent CLABSI.
Methods: A single-centre, parallel group, randomized controlled trial was conducted in a
929-bed tertiary referral hospital. Hospital inpatients requiring a peripherally inserted
central catheter were randomized to chlorhexidine gluconate (CHG) or polyhexamethylene
biguanide (PHMB) disc dressing group. Dressings were replaced every seven
days, or earlier, if clinically required. Participants were followed until device removal or
hospital discharge. Feasibility outcomes included: proportion of potentially eligible participants
who were enrolled; proportion of protocol violations; and proportion of patients
lost to follow-up. Clinical outcomes were: CLABSI incidence, diagnosed by a blinded
infection control practitioner; all-cause bloodstream infection (BSI); and product-related
adverse events.
Findings: Of 143 patients screened, 101 (71%) were eligible. Five (3.5%) declined participation.
There was one post-randomization exclusion. Two (2%) protocol violations
occurred in the CHG group. No patients were lost to follow-up. Three (3%) BSIs occurred;
two (2%) were confirmed CLABSIs (one in each group) and one a mucosal barrier injuryrelated
BSI. A total of 1217 device-days were studied, resulting in 1.64 CLABSIs per 1000
catheter-days. One (1%) disc-related adverse event occurred in the CHG group.
Conclusion: Disc dressings containing PHMB are safe to use for infection prevention at
catheter insertion sites. An adequately powered trial to compare PHMB and CHG discs is
feasible | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.publisher | Elsevier | |
dc.relation.ispartofpagefrom | 223 | |
dc.relation.ispartofpageto | 228 | |
dc.relation.ispartofissue | 3 | |
dc.relation.ispartofjournal | Journal of Hospital Infection | |
dc.relation.ispartofvolume | 96 | |
dc.subject.fieldofresearch | Clinical sciences | |
dc.subject.fieldofresearch | Health services and systems | |
dc.subject.fieldofresearch | Public health | |
dc.subject.fieldofresearchcode | 3202 | |
dc.subject.fieldofresearchcode | 4203 | |
dc.subject.fieldofresearchcode | 4206 | |
dc.title | Chlorhexidine gluconate or polyhexamethylene biguanide disc dressing to reduce the incidence of central-line-associated bloodstream infection: a feasibility randomized controlled trial (the CLABSI trial) | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
dc.description.version | Accepted Manuscript (AM) | |
gro.faculty | Griffith Health, School of Nursing and Midwifery | |
gro.rights.copyright | © 2017 The Healthcare Infection Society. Published by Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited. | |
gro.hasfulltext | Full Text | |
gro.griffith.author | Larsen, Emily N. | |