Universität zu Köln

Lutz, Juergen Thomas, Diener, Isabel Victoria, Freiberg, Kerstin, Zillmann, Robert, Shah-Hosseini, Kija ORCID: 0000-0001-9616-6942, Seifert, Harald, Berger-Schreck, Bettina and Wisplinghoff, Hilmar (2016). Efficacy of two antiseptic regimens on skin colonization of insertion sites for two different catheter types: a randomized, clinical trial. Infection, 44 (6). S. 707 - 713. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Purpose Catheter-related bloodstream infections affect patients in surgical and intensive care settings worldwide, causing complications, aggravation of existing symptoms and increased length of stay. The trial aimed at comparing two registered skin antiseptics with respect to their residual and therefore infection-preventing effects. Methods In a parallel, monocentric, prospective, triple-blind, randomized trial the difference in bacterial recolonization of catheter skin sites in central venous (CVC) and epidural catheters (EC) was investigated by comparing two alcoholic-based skin disinfectants. Patients receiving planned surgeries or intensive care were eligible for the trial. Those in the trial group received skin disinfection with the additive octenidine dihydrochloride (OCT) (n = 51), those in the control group were treated with benzalkonium chloride as additive (BAC) (n = 59) prior to catheter insertion. Randomization was carried out by assigning patients to groups week-wise. Endpoints of the investigation were skin colonization of the catheter site counted in colony forming units per swab at three time points: (1) prior to catheter insertion, on untreated skin; (2) directly after catheter insertion, prior to sterile coverage; (3) 48 h after catheter insertion. The hypothesis was tested by a Wilcoxon test with a two-sided alpha = 5 %. Results From second to third swab, recolonization of the catheter-surrounding skin was significantly lower in the trial group for both sorts of catheters: delta 2-3 OCT group: 0.72 (95 % CI: 0.42; 1.02); delta 2-3 BAC group: 1.97 (95 % CI: 1.45; 2.50); p < 0.001. None of the patients enrolled developed a catheter-related blood stream infection (CRBSI) during follow-up. Conclusions Previous studies have shown that skin colonization is strongly associated with the occurrence of CRBSI. This randomized controlled trial supports the observations made in previous trials that octenidine dihydrochloride in disinfectants is more effective than agents containing other additives with regard to skin recolonization surrounding CVC and EC insertion sites. Therefore, it is likely to also reduce the risk of CRBSI in these patient groups. The trial was approved by the North Rhine Medical Association in July 2014 (application-no.: 2014222).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lutz, Juergen Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Diener, Isabel Victoria UNSPECIFIED UNSPECIFIED UNSPECIFIED Freiberg, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Zillmann, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah-Hosseini, Kija UNSPECIFIED orcid.org/0000-0001-9616-6942 UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Berger-Schreck, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Wisplinghoff, Hilmar UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-254342
DOI:	10.1007/s15010-016-0899-6
Journal or Publication Title:	Infection
Volume:	44
Number:	6
Page Range:	S. 707 - 713
Date:	2016
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD-STREAM INFECTIONS; OCTENIDINE DIHYDROCHLORIDE; CARE; DISINFECTION; PREVENTION Multiple languages Infectious Diseases Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25434