Chlorhexidine Bathing in Critically Ill Children

Istanbul Medeniyet University247 enrolled

Overview

Central line-associated bloodstream infections are associated with increased mortality, morbidity, and length of hospital stay. The incidence has decreased significantly with the strict implementation of preventive bundle cares and checklists in intensive care units. Bathing with solutions containing chlorhexidine has been included in preventive strategies in recent years. Although some studies have shown that chlorhexidine bathing reduces the frequency of hospital-associated infections, there are important differences in management of practice and adherence to practice in different facilities. The majority of the studies conducted include adult patients. According to the CDC guidelines, chlorhexidine bathing is recommended for children over 2 months of age to prevent Central line-associated bloodstream infections. The aim of this study is to investigate the effect of daily bathing with 2% chlorhexidine gluconate solution in preventing Central line-associated bloodstream infections in pediatric patients with temporary central venous catheters.

In patients with a central catheter for longer than 48 hours, the diagnosis of bloodstream infection will be recorded as laboratory-confirmed bloodstream infections according to CDC diagnostic criteria. Microorganisms detected in cultures will be classified as gram-positive and gram-negative or fungal agents. Infection with the resistant microorganism will be compared with the control group. Catheter colonization; be defined as bacterial growth of more than 15 colonies in the semiquantitative culture or 1000 colonies in the quantitative culture of the catheter segment or hub without clinical symptoms. Patients in both groups with a central catheter for longer than 48 hours will be treated with a standard bath every day. In addition to the control group, patients in the study group will be treated daily with 2% chlorhexidine gluconate, and the patients in these two groups will be compared in terms of Central line-associated bloodstream infections and catheter colonization.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

Eligibility

Sex: ALLMin age: 2 MonthsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients between the ages of 2 months and 18 years who had a temporary central venous catheter * Patients whose follow-up is continued for at least 48 hours with a central venous catheter Exclusion Criteria: * Patients younger than 2 months of age * Patients with a intensive care unit stay shorter than 48 hours * Immunosuppressive patients * Patients with a history of allergic reaction to chlorhexidine * Patients with skin lesions that interfere with skin cleansing with chlorhexidine * Patients whose family did not give consent

Outcomes

Primary Outcomes

Central line-associated bloodstream infection

The main objective of this research was to perform a randomized controlled trial to evaluate the difference between daily 2% CHG bathing and daily standard soap with water bathing concerning the occurrence of CLABSI in critically ill children in the PICU who had undergone CVC placement.

Time frame: 2 years.

Secondary Outcomes

Microorganisms that cause catheter colonization in patients which applied standard bathing

The secondary aims were to assess the rate of catheter colonization in both groups and to identify the microorganisms responsible for CLABSI and catheter colonization in this pediatric population.