Multicenter, multinational, prospective cohort study of the impact of chlorhexidine impregnated versus plain central lines on central line-associated bloodstream infections - 11/07/25
, Ruijie Yin, PhD a, Zhilin Jin, PhD a, Mat Nor Mohd Basri, MD c, Lai Yin Hoong, MD c, Fatimah Mohamad, MD c, Amani El-Kholy, MD d, Victor Bayani, RN d, Rana Hatem, MD d, Sheila Nainan Myatra, MD e, Linda Castro Páez, RN f, Mohit Kharbanda, MD g, Bikas Nag, RN g, Ertugrul Guclu, MD h, Esra Olmez Gazioglu, MD h, Sunita Gupta, MD i, Nellie Tumu, RN jRésumé |
Background |
We compared the efficacy of chlorhexidine-impregnated central lines (CLs) with plain CLs in preventing central line-associated bloodstream infections (CLABSIs) in critically ill patients.
Methods |
The study was conducted from April 2023 to August 2024 in 8 hospitals across India, Malaysia, Papua New Guinea, Colombia, Egypt, and Turkey. Data were collected prospectively using the INICC Surveillance Online System. Cases and controls were recruited simultaneously. Data were analyzed using t tests, χ² tests, and Fisher exact tests when indicated. Relative risks (RR) and their corresponding 95% confidence intervals (CI) were calculated.
Results |
A total of 6,672 patients were included. Patients with impregnated CLs had 4,721 CL-days, while those with plain CLs had 18,822 CL-days. The CLABSI rate in patients with impregnated CLs was 1.48 per 1,000 CL-days, compared to 4.78 per 1,000 CL-days in those with plain CLs (RR=0.31, 95%CI=0.14-0.67, P=.003). A subgroup analysis excluding patients with hemodialysis but using central venous catheters (CVCs) showed 1.72 CLABSIs per 1,000 CL-days in patients with impregnated CVCs compared to 5.84 per 1,000 CL-days in those with plain CVCs (RR=0.29, 95%CI=0.12-0.68, P=.004).
Conclusions |
This study highlights the significant benefits of impregnated CLs over plain CLs in reducing CLABSI rates, achieving a 69% decrease in incidence.
Le texte complet de cet article est disponible en PDF.Highlights |
• | This study evaluates the impact of CHG-impregnated central lines on the CLABSI rate. |
• | An intervention was conducted in 12 ICUs across eight hospitals in 6 countries. |
• | A total of 6,672 patients were studied. |
• | The CLABSI rate was lower in patients with impregnated catheters than those with plain ones. |
Key Words : Impregnated catheters, Chlorhexidine-impregnated catheters, Middle-income countries, Developing countries, Limited resources countries, Network
Plan
| Funding/support: The funding for the design, development, maintenance, technical support, data validation, and report generation of ISOS and the activities conducted at INICC headquarters was provided by the corresponding author, Victor D. Rosenthal, and the INICC Foundation. Teleflex provided financial support for the manuscript's editing but did not influence or contribute to the data analysis or the editing of the manuscript. |
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| Conflicts of interest: Rosenthal, V.D. is an occasional speaker for Teleflex but does not have employment, stock ownership, honoraria, paid expert testimony, or patent applications/registrations associated with Teleflex. The remaining authors declare that they have no financial or personal relationships with other individuals or organizations that could inappropriately influence their work, and they have no potential competing interests, including but not limited to roles as speakers, employment, stock ownership, honoraria, paid expert testimony, or patent applications/registrations. |
Vol 53 - N° 8
P. 862-868 - août 2025 Retour au numéro
Article précédent
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