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Published in: Surgery Today 12/2014

01-12-2014 | Original Article

The differences in microorganism growth on various dressings used to cover injection sites: inspection of the risk of catheter-related bloodstream infections caused by Gram-negative bacilli

Authors: Hideki Kawamura, Norihiko Takahashi, Masahiro Takahashi, Akinobu Taketomi

Published in: Surgery Today | Issue 12/2014

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Abstract

Purposes

Sepsis caused by Gram-negative bacilli (GNB) is the most serious catheter-related bloodstream infection. However, the cause(s) of GNB propagation on the skin around needle or catheter insertion sites remain unclear. This observational study aimed to assess the differences in the microbial growth among various types of dressings used to cover injection sites, with a particular focus on GNB.

Methods

We analyzed the bacterial populations on three types of surgical dressings; Tegaderm I.V. (semi-permeable, 27 sheets), IV3000 (highly permeable, 34 sheets) and Tegaderm CHG (chlorhexidine-impregnated, 26 sheets). The peripheral catheter site dressing was replaced every 3 days or when there was leakage or pain at the catheter site.

Results

Bacterial growth was observed in all Tegaderm I.V. and IV3000 sheets and in only one (3.8 %) Tegaderm CHG sheet. The GNB detection rate was significantly lower in the IV3000 group (2.9 %) than in the Tegaderm I.V. group (63.0 %). No GNB growth was identified in the Tegaderm CHG group.

Conclusions

Semi-permeable dressings were insufficient to prevent GNB infections, whereas highly permeable or chlorhexidine-impregnated dressings could prevent GNB infections. Chlorhexidine-impregnated dressings can control almost all bacterial growth.
Literature
1.
go back to reference O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2002;9:1–29. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2002;9:1–29.
2.
go back to reference Crosby CT, Tsj E, Lambert PA, Adams D. Preoperative skin preparation: a historical perspective. Br J Hosp Med. 2009;70:579–82.CrossRef Crosby CT, Tsj E, Lambert PA, Adams D. Preoperative skin preparation: a historical perspective. Br J Hosp Med. 2009;70:579–82.CrossRef
3.
go back to reference Popovich KJ, Hota B, Hayes R, Weinstein RA, Hayden MK. Effectiveness of routine patient cleansing with chlorhexidine gluconate for infection prevention in the medical intensive care unit. Infect Control Hosp Epidemiol. 2009;30:959–63.PubMedCrossRef Popovich KJ, Hota B, Hayes R, Weinstein RA, Hayden MK. Effectiveness of routine patient cleansing with chlorhexidine gluconate for infection prevention in the medical intensive care unit. Infect Control Hosp Epidemiol. 2009;30:959–63.PubMedCrossRef
4.
go back to reference Periti P. Current treatment of sepsis and endotoxaemia. Expert Opin Pharmacother. 2000;1:1203–17.PubMedCrossRef Periti P. Current treatment of sepsis and endotoxaemia. Expert Opin Pharmacother. 2000;1:1203–17.PubMedCrossRef
5.
go back to reference Mermel LA. What is the predominant source of intravascular catheter infections? Clin Infect Dis. 2011;52:211–2.PubMedCrossRef Mermel LA. What is the predominant source of intravascular catheter infections? Clin Infect Dis. 2011;52:211–2.PubMedCrossRef
6.
go back to reference Timsit JF, Mimoz O, Mourvillier B, Souweine B, Garrouste-Orgeas M, Alfandari S, et al. Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med. 2012;186:1272–8.PubMedCrossRef Timsit JF, Mimoz O, Mourvillier B, Souweine B, Garrouste-Orgeas M, Alfandari S, et al. Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med. 2012;186:1272–8.PubMedCrossRef
7.
go back to reference Velasco E, Soares M, Byington R, Martins CA, Schirmer M, Dias LM, et al. Prospective evaluation of the epidemiology, microbiology, and outcome of bloodstream infections in adult surgical cancer patients. Eur J Clin Microbiol Infect Dis. 2004;23:596–602.PubMedCrossRef Velasco E, Soares M, Byington R, Martins CA, Schirmer M, Dias LM, et al. Prospective evaluation of the epidemiology, microbiology, and outcome of bloodstream infections in adult surgical cancer patients. Eur J Clin Microbiol Infect Dis. 2004;23:596–602.PubMedCrossRef
8.
go back to reference Pujol M, Hornero A, Saballs M, Argerich MJ, Verdaguer R, Cisnal M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007;67:22–9.PubMedCrossRef Pujol M, Hornero A, Saballs M, Argerich MJ, Verdaguer R, Cisnal M, et al. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007;67:22–9.PubMedCrossRef
9.
go back to reference Reynolds MG, Tebbs SE, Elliott TS. Do dressings with increased permeability reduce the incidence of central venous catheter related sepsis? Intensive Crit Care Nurs. 1997;13:26–9.PubMedCrossRef Reynolds MG, Tebbs SE, Elliott TS. Do dressings with increased permeability reduce the incidence of central venous catheter related sepsis? Intensive Crit Care Nurs. 1997;13:26–9.PubMedCrossRef
10.
go back to reference Humphreys H, Newcombe RG, Enstone J, Smyth ET, McIlvenny G, Fitzpatrick F, et al. Four country healthcare associated infection prevalence survey 2006: risk factor analysis. J Hosp Infect. 2008;69:249–57.PubMedCrossRef Humphreys H, Newcombe RG, Enstone J, Smyth ET, McIlvenny G, Fitzpatrick F, et al. Four country healthcare associated infection prevalence survey 2006: risk factor analysis. J Hosp Infect. 2008;69:249–57.PubMedCrossRef
11.
go back to reference Zingg W, Pittet D. Peripheral venous catheter: an under-evaluated problem. Int J Antimicrob Agents. 2009;34:38–42.CrossRef Zingg W, Pittet D. Peripheral venous catheter: an under-evaluated problem. Int J Antimicrob Agents. 2009;34:38–42.CrossRef
12.
go back to reference Timsit JF, Schwebel C, Bouadma L, Geffroy A, Garrouste-Orgeas M, Pease S, et al. Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA. 2009;301:1231–41.PubMedCrossRef Timsit JF, Schwebel C, Bouadma L, Geffroy A, Garrouste-Orgeas M, Pease S, et al. Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA. 2009;301:1231–41.PubMedCrossRef
13.
go back to reference Koerner RJ, Morgan S, Ford M, Orr KE, McComb JM, Gould FK. Outbreak of gram-negative septicaemia caused by contaminated continuous infusions prepared in a non-clinical area. J Hosp Infect. 1997;36:285–9.PubMedCrossRef Koerner RJ, Morgan S, Ford M, Orr KE, McComb JM, Gould FK. Outbreak of gram-negative septicaemia caused by contaminated continuous infusions prepared in a non-clinical area. J Hosp Infect. 1997;36:285–9.PubMedCrossRef
14.
go back to reference Ball C. Hospital-acquired bacteraemia—surveillance and guidelines for practice. Intensive Crit Care Nurs. 2001;17:249–53.PubMedCrossRef Ball C. Hospital-acquired bacteraemia—surveillance and guidelines for practice. Intensive Crit Care Nurs. 2001;17:249–53.PubMedCrossRef
15.
go back to reference Raad II, Hanna HA. Intravascular catheter-related infections: new horizons and recent advances. Arch Intern Med. 2002;162:871–8.PubMedCrossRef Raad II, Hanna HA. Intravascular catheter-related infections: new horizons and recent advances. Arch Intern Med. 2002;162:871–8.PubMedCrossRef
16.
go back to reference O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Suppl 1):S1–34.PubMedCrossRef O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4 Suppl 1):S1–34.PubMedCrossRef
17.
go back to reference Jones A. Dressings for the management of catheter sites. JAVA. 2004;9:26–33.CrossRef Jones A. Dressings for the management of catheter sites. JAVA. 2004;9:26–33.CrossRef
18.
go back to reference Keenlyside D. Avoiding an unnecessary outcome. A comparative trial between IV3000 and a conventional film dressing to assess rates of catheter-related sepsis. Prof Nurse. 1993;8:288–91.PubMed Keenlyside D. Avoiding an unnecessary outcome. A comparative trial between IV3000 and a conventional film dressing to assess rates of catheter-related sepsis. Prof Nurse. 1993;8:288–91.PubMed
19.
go back to reference Vu-Thien H, Darbord JC, Moissenet D, Dulot C, Dufourcq JB, Marsol P, et al. Investigation of an outbreak of wound infections due to Alcaligenes xylosoxidans transmitted by chlorhexidine in a burns unit. Eur J Clin Microbiol Infect Dis. 1998;17:626–724. Vu-Thien H, Darbord JC, Moissenet D, Dulot C, Dufourcq JB, Marsol P, et al. Investigation of an outbreak of wound infections due to Alcaligenes xylosoxidans transmitted by chlorhexidine in a burns unit. Eur J Clin Microbiol Infect Dis. 1998;17:626–724.
20.
go back to reference Higgins CS, Murtough SM, Williamson E, Hiom SJ, Payne DJ, Russell AD, et al. Resistance to antibiotics and biocides among non-fermenting Gram-negative bacteria. Clin Microbiol Infect. 2001;7:308–15.PubMedCrossRef Higgins CS, Murtough SM, Williamson E, Hiom SJ, Payne DJ, Russell AD, et al. Resistance to antibiotics and biocides among non-fermenting Gram-negative bacteria. Clin Microbiol Infect. 2001;7:308–15.PubMedCrossRef
Metadata
Title
The differences in microorganism growth on various dressings used to cover injection sites: inspection of the risk of catheter-related bloodstream infections caused by Gram-negative bacilli
Authors
Hideki Kawamura
Norihiko Takahashi
Masahiro Takahashi
Akinobu Taketomi
Publication date
01-12-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 12/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-0935-z

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