Multicenter, multinational, prospective cohort study of the impact of chlorhexidine impregnated versus plain central lines on central line-associated bloodstream infections

Rosenthal, Victor Daniel and Yin, Ruijie and Jin, Zhilin and Mat Nor, Mohd Basri and Lai, Yin Hoong and Mohamad, Fatimah and El-Kholy, Amani and Bayani, Victor and Hatem, Rana and Myatra, Sheila Nainan and Páez, Linda Castro and Kharbanda, Mohit and Nag, Bikas and Guclu, Ertugrul and Gazioglu, Esra Olmez and Gupta, Sunita and Tumu, Nellie (2025) Multicenter, multinational, prospective cohort study of the impact of chlorhexidine impregnated versus plain central lines on central line-associated bloodstream infections. American Journal of Infection Control, 53 (8). pp. 862-868. ISSN 0196-6553 E-ISSN 1527-3296

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Abstract

Background: We compared the efficacy of chlorhexidine-impregnated central lines (CLs) with plain CLs in preventing central line-associated bloodstream infections (CLABSIs) in critically ill patients. Methods: The study was conducted from April 2023 to August 2024 in 8 hospitals across India, Malaysia, Papua New Guinea, Colombia, Egypt, and Turkey. Data were collected prospectively using the INICC Surveillance Online System. Cases and controls were recruited simultaneously. Data were analyzed using t tests, χ² tests, and Fisher exact tests when indicated. Relative risks (RR) and their corresponding 95% confidence intervals (CI) were calculated. Results: A total of 6,672 patients were included. Patients with impregnated CLs had 4,721 CL-days, while those with plain CLs had 18,822 CL-days. The CLABSI rate in patients with impregnated CLs was 1.48 per 1,000 CL-days, compared to 4.78 per 1,000 CL-days in those with plain CLs (RR=0.31, 95%CI =0.14-0.67, P= .003). A subgroup analysis excluding patients with hemodialysis but using central venous catheters (CVCs) showed 1.72 CLABSIs per 1,000 CL-days in patients with impregnated CVCs compared to 5.84 per 1,000 CL-days in those with plain CVCs (RR=0.29, 95%CI =0.12-0.68, P= .004). Conclusions: This study highlights the significant benefits of impregnated CLs over plain CLs in reducing CLABSI rates, achieving a 69% decrease in incidence.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Impregnated catheters Chlorhexidine-impregnated catheters Middle-income countries Developing countries Limited resources countries Network
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care Sultan Ahmad Shah Medical Centre (SASMEC)
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	18 Dec 2025 15:36
Last Modified:	18 Dec 2025 15:36
Queue Number:	2025-12-Q786
URI:	http://irep.iium.edu.my/id/eprint/125559

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