Evaluation of Antimicrobial Effectiveness of a Chlorhexidine Gluconate-Impregnated Intravenous Catheter Dressing.

INTRODUCTION

Standard intravenous catheter securement dressings permit microbial regrowth at the insertion site, which can contribute to hospital-onset bloodstream infections. We evaluated the antimicrobial activity of a chlorhexidine gluconate (CHG)-impregnated intravenous dressing.

METHODS

Antimicrobial performance was assessed using an in vitro assay against eight microorganisms after 168-hour exposure to CHG dressings and two randomised, controlled studies in healthy adults comparing CHG and placebo dressings. Skin flora were measured at baseline and after 24, 72, and 168 hours on skin without antiseptic preparation (n=21 study participants) and on skin prepared with 70% isopropyl alcohol or 2% CHG to assess regrowth suppression (n=31 study participants).

RESULTS

In vitro, CHG dressings reduced bacteria, yeast, and mould populations after 168 hours. In vivo, CHG dressings significantly reduced skin flora compared with the control on skin without antiseptic preparation at 24 (-1.49 log10 CFU/cm2 decrease), 72 (-2.10 log10 CFU/cm2 decrease), and 168 hours (-2.74 log10 CFU/cm2 decrease; P<0.0001). Following isopropyl alcohol skin preparation, CHG dressings significantly suppressed microbial regrowth compared with control at 24 (-1.03 log10 CFU/cm2 decrease), 72 (-1.31 log10 CFU/cm2 decrease), and 168 hours (-1.42 log10 CFU/cm2 decrease; P<0.0001). Similar reductions were observed following skin preparation with 2% CHG at 24 (-0.87 log10 CFU/cm2 decrease), 72 (-1.27 log10 CFU/cm2 decrease), and 168 hours (-1.34 log10 CFU/cm2 decrease; P<0.0001).

DISCUSSION: The CHG-impregnated intravenous dressing demonstrated sustained, broad-spectrum antimicrobial activity in vitro and suppressed skin flora regrowth for up to seven days.

CONCLUSIONS

These data support the use of CHG dressings as an adjunct to standard insertion and maintenance practices to reduce insertion-site microbial burden during clinically relevant dwell times.