Efficacy of a chlorhexidine-gluconate impregnated patch for prevention of catheter-related infections in pediatric patients: systematic review and meta-analysis

Autores: Rivas Ruíz Rodolfo, Villasis Keever Miguel Angel, Miranda Novales María Guadalupe, Castelán Martínez Daniel, Vivanco Muñoz Nalleli, Chico Barba Gabriela, Clark M Patricia

Resumen

Background: Nosocomial infections are risk factors related to intrahospital mortality. Among other factors, these infections are strongly associated with invasive devices. In pediatric patients, the central venous catheter (CVC) is one of the most frequently related deviceassociated bloodstream infections. The aim of this study was to evaluate the efficacy and safety of a chlorhexidine-gluconate impregnate patch (CHGp) in reducing infections related to CVC in pediatric patients. Methods: We conducted a systematic review and meta-analysis. An electronic search of the literature (Medline, EMBASE, Lilacs and the Cochrane Library Plus) from 1966 to December 2010 was carried out for clinical trials comparing the CHGp vs. standard case management for prevention of catheter tip colonization (CTC); bloodstream infections (BSI) were retrieved. Results: Only two clinical trials were found with a total of 850 participants. Patients randomized to the CHGp group showed a lower incidence of CTC than the control group (14% vs. 25%), relative risk [RR]: 0.61, 95% confidence interval [CI 95% (0.45, 0.81)], p = 0.001), with a number needed to treat of 11. BSI showed a RR: 1.14, ([CI 95% (0.57, 2.28)], p = 0.71). Adverse events were found mainly in the CHGp group and were described as local skin reactions in 5.6% (RR 8.17 [95% CI: 1.19-56.14], p = 0.04). Local necrosis was present in only two infants of very low birth weight (0.48%). Conclusions: This meta-analysis demonstrated that the chlorhexidine-gluconate impregnated patch is effective in reducing CVC-related infections in the pediatric population. Serious adverse events are rare.

Palabras clave: Central venous catheters infections related to central venous catheters meta-analysis chlorhexidine-gluconate impregnated patch.

2011-12-02   |   1,004 visitas   |   Evalua este artículo 0 valoraciones

Vol. 68 Núm.5. Septiembre-Octubre 2011 Pags. 349-35 Bol Med Hosp Infant Mex 2011; 68(5)