Chlorhexidine gluconate transparent dressing does not decrease central line‐associated bloodstream infection in critically ill patients: A randomized controlled trial.

Background: Central line‐associated blood stream infections are accompanied by increased mortality and health care costs. The application of different types of dressings in infection control has not been fully investigated to date. Aim: To assess the effects of two different dressing types on central line‐associated bloodstream infections. Methods: A randomized, nonblinded, controlled trial was conducted. Central lines were randomly allocated to intervention (chlorhexidine gluconate transparent dressing, n = 259) and control groups (standard dressing, n = 215). The central line‐associated bloodstream infection rate was assessed. Results: A statistically nonsignificant difference was noted in the overall central line‐associated bloodstream infection rates between the two groups. The frequency of dressing changes in the patients with the chlorhexidine gluconate transparent dressing was significantly lower than that in the patients with a standard dressing. The predominant type of infectious microorganisms isolated from the central line‐associated bloodstream infection episodes was Gram‐negative bacteria (57.2%). Gram‐positive bacteria and fungi were noted at lower percentages (28.5% and 14.3%, respectively). Conclusion: The use of a chlorhexidine gluconate transparent dressing does not decrease the central line‐associated bloodstream infection rate, although it decreases the frequency of dressing changes so may save nursing time. SUMMARY STATEMENT: What is already known about this topic? The use of a chlorhexidine gluconate transparent dressing has been reported to significantly reduce central line‐associated bloodstream infections or maintain low central line‐associated bloodstream infections in Western countries, but few studies have been carried out in Asian countries.The chlorhexidine dressing does not decrease central line‐associated bloodstream infections due to the presence of Gram‐negative bacteria.It has been reported that nurses prefer the chlorhexidine gluconate transparent dressing over the standard dressing. What this paper adds? Compared with the standard dressing, the chlorhexidine gluconate transparent dressing does not significantly decrease the central line‐associated bloodstream infection rate.The predominant infectious microorganisms isolated from central line-associated bloodstream infections episodes were Gram-negative bacteria.The cost of the chlorhexidine gluconate transparent dressing was significantly higher than that of the standard dressing, although the former could save nursing time due to the decreased frequency of dressing changes. The implications of this paper are as follows: The use of chlorhexidine gluconate transparent dressing does not offer any additional benefit in controlling infection.Further studies are required to identify ways to control the colonization or infection of Gram‐negative bacteria in patients because Gram‐negative bacteria are the predominant infectious microorganisms that cause central line‐associated bloodstream infection.The use of a chlorhexidine gluconate transparent dressing is proposed as an alternative choice that can reduce ICU nursing time in hospital settings and therefore should be considered by nursing managers for human resource cost control. [ABSTRACT FROM AUTHOR]