Author(year) | Country | Population | Numbers of participants(Chlorhexidine / Control) | Catheter Type | Chlorhexidine-impregnated dressing Intervention | Definition of Catheter Colonization | Definition of CRBSI | Conclusion |
---|---|---|---|---|---|---|---|---|
Arvaniti 2012 | Greece | ICU patients who required a CVC for ≥3 days | 150/156 | CVC | after the first 24 h of catheterization, a Biopatch was placed underneath the transparent dressing, And the Biopatch was changed every 3 days, | Quantitative CVC tip culture with > 1000 CFU/mL and no systemic signs of sepsis | Quantitative CVC tip culture with > 1000 CFU/mL with systemic signs of sepsis | Chlorhexidine-impregnated sponges and Oligon catheters as single preventive measures did not reduce catheter colonization or catheter-related infections. |
Biehl 2016 | Germany | Patients undergoing chemotherapy with an expected duration of chemotherapy- induced neutropenia of ≥5 days and an expected CVC use of ≥10 days | 307/306 | Non-tunneled CVC | Dressings were applied within 2 h of CVC placement and changed every 3 ± 1 days. | Not availabe | The results from blood and CVC tip cultures | The application of chlorhexidine containing catheter securement dressings reduces the incidence of definite or probable CRBSI in neutropenic patients. |
Chambers 2005 | New Zealand | Adult patients undergoing chemotherapy in a haematology unit. | 58/54 | Long-term, tunneled and cuffed CVC | The Chlorhexidine impregnated dressing were applied to the exit site as soon the oozing had stopped following intravascular catheter insertion, and changed as needed or weekly. | Not available | Fever and positive blood cultures without alternative infection source and catheter tip culture with > 15 colonies of the same organism | Chlorhexidine dressings reduced the incidence of exit-site/tunnel infections of indwelling tunnelled intravascular catheters without prolonging catheter survival in neutropenic patients |
Garland 2001 | USA | ICU neonates with CVC expected to remain in place a minimum of 48 h | 335/370 | CVC and tunneled (Broviac) CVC | The Chlorhexidine impregnated dressing were applied after catheterization and changed for every 7 days or as needed. | Semiquantitative catheter colony count > 15 CFU | Clinical infection with same organism isolated from catheter tip and blood | The Chlorhexidine impregnated dressing is effective in protect against the catheter-tip colonization. |
Gereker 2017 | Turkey | Pediatric hematologyoncology (PHO) population over 2 months of age with expected CVC duration over 48 h | 14/13 | CVC | Care bundle with Chlorhexidine impregnated dressing being used | Not availale | Blood culture | There was no difference between the two groups with chlorhexidine dressing or advanced dressings in terms of CRBSI development. |
Levy 2005 | Israel | Cardiac ICU pediatrics requiring CVC for minimum of 48 h | 74/71 | Short-term, nontunneled CVC | The Chlorhexidine impregnated dressing were applied after catheterization and changed whenever needed. | >  15 CFU by the roll-plate technique, no signs of infection | Bacteremia with isolation of the same organism from CVC tip and blood | The Chlorhexidine impregnated dressing is safe and significantly reduces the rates of CVC colonization in infants and children after cardiac surgery. |
Pedrolo 2014 | Brazil | Adult ICU patients | 43/42 | CVC | chlorhexidine antimicrobial dressing was changed every 7 days | Not available | Infection variables: temperature > 38 °C, systolic blood pressure < 90 mmHg, oliguria< 20 ml/h, tenderness, pain or swelling on palpation, hyperemia, cyanosis or discharge at the catheter opening; And further verified by blood culture or a culture of the catheter tip | The chlorhexidine antimicrobial dressing is not effective in reducing primary bloodstream infection when compared to the gauze and tape dressing. |
Roberts 1998 | Australia | Adult ICU patients receiving CVC over a 7-week period | 17/16 | CVC | Chlorhexidine impregnated dressing was changed every fifth day or as needed. | Same organism from CVC tip and exit site, no clinical infection | Clinical infection with same organism isolated from catheter tip (and/or exit site) and blood | No statistical difference was found between the two groups with regard to CVC or exit-site colonisation. |
Ruschulte 2008 | Germany | Adults receiving chemotherapy with catheter expected for minimum of 5 d | 300/301 | Triple-lumen CVC | The Chlorhexidine impregnated dressing were applied after catheterization | Not available | Clinical evidence of infection and time-to-positivity method used with CVC and peripherally drawn blood cultures | The use of chlorhexidine-impregnated wound dressings significantly reduced the incidence of CVC-related infections in patients receiving chemotherapy. |
Timsit 2009 | France | Adult ICU patients requiring catheter minimum of 48 h | 817/819 | CVC and/ or arterial catheter | The Chlorhexidine impregnated dressing was changed 24 h after catheter insertion (day 1) and then every 3 days in the 3-day group and every 7 days in the 7-day group | Quantitative CVC tip culture ≥1000 CFUs/mL | Clinical infection without alternative source, peripheral blood drawn immediately prior to or within 48 h following catheter removal and quantitative catheter tip culture isolating the same organism, or confirmed using differential time to positivity test | The use of Chlorhexidine impregnated dressings decreased the risk of major catheter- related infections by 60% despite a low baseline infection rate. |
Timsit 2012 | France | ICU patients with vascular catheters inserted for an expected duration of more than 48 h | 938/476 | CVC | The dressings were changed 24 h after catheter insertion (Day 1) then every 3 or 7 days according to standard practice in each ICU | Quantitative CVC tip culture > 1000 CFU/mL and no systemic signs of sepsis | Correlation between peripheral blood culture and quantitative tip culture without other likely source | The Chlorhexidine-impregnated gel dressings decrease by 60% the risk of CRBSI in the ICU. |
Yu 2015 | China | Adult internal ICU patients | 189/162 | CVC | Chlorhexidine impregnated dressing was changed every 7 days or as needed. | Not available | Infection variables: blood cultures or catheter tip cultures | The Chlorhexidine impregnated dressing cannot effectively reduce the incidence of CLABSI, and the cost is higher, but it can effectively reduce the number of dressing changes and save labor costs |