Chlorhexidine-impregnated dressing: An efficient weapon against catheter-related bloodstream infection?

摘要

Central catheters are of common use in ICUs world- wide. Central venous catheters are inserted daily for catecholamine infusion, parenteral nutrition, and in case of difficult peripheral vascular access, whereas arterial catheters and pulmonary artery catheters are used for monitoring critically ill patients. The major issue with all these central catheters is not insertion-related mechanical complications but infectious complications. Among these, catheter-related bloodstream infections (CRBSIs) are a serious public health issue as they increase morbidity and healthcare costs (1). Several strategies have been investigated to prevent these infections, and evidence-based recommendations have been published and implemented in several institutions (2). For short-term catheters used in ICU, the main way of contamination is the extraluminal route (3). That is why skin preparation and dressing protocols are of utmost importance in this situation. Chlorhexidine-based skin antisepsis is well recognized as an efficient strategy while results concerning the use of chlorhexidine-impregnated dressing are still controversial.