RESUMEN
Objective:To evaluate the efficacy of disposable disinfection cap in preventing catheter-related blood stream infections (CRBSIs).Methods:Literature on the prevention of CRBSIs by disposable disinfection caps were retrieved from CNKI, Wanfang Database, VIP database, Chinese Biomedical Literature Database, PubMed, Cochrane Library, Embase and Web of Science databases. The retrieval period was from the database construction to June 30, 2022. After literature screening, data extraction and quality evaluation were independently carried out by 2 researchers, RevMan5.4 software was used for analysis.Results:A total of 12 articles were included, including 9 832 patients. Meta-analysis results showed that compared with conventional manual disinfection, disposable disinfection cap could reduce the incidence of CRBSIs, and the difference was statistically significant ( RR = 0.58, 95% CI 0.43-0.79, P<0.01). Disposable disinfection cap could reduce the incidence of CRBSIs in adults, but there was no significant difference in the incidence of CRBSIs in children ( P>0.05). It could reduce the incidence of CRBSIs in patients with indwelling vascular catheters in ICU ( RR = 0.58, 95% CI 0.38-0.89, P<0.05), but there was no statistical difference in the incidence of CRBSIs in patients without indwelling vascular catheters in ICU ( P>0.05). In addition, the compliance of the use of disinfection caps by nursing staff was improved by 80% - 90% and the treatment cost was saved by about 282 - 464 dollars. Conclusions:Disposable disinfection caps can reduce the occurrence of CRBSIs, improve the disinfection compliance of nursing staff, and save the hospitalization cost of patients. It is suggested to be popularized in clinical practice.
RESUMEN
[Abstract] Objective To evaluate the effectiveness of chlorhexidine/silver sulfadiazine catheters vs. conventional standard catheters in the prevention of catheter-related bloodstream infections with bundles. Methods We searched the Cochrane Library, Embase, Medline, CINAHL and Web of Science databases from construction to March 2019 for randomized controlled trials to compare the use of chlorhexidine/silver sulfadiazine catheters and conventional standard catheters. Cochrane bias risk assessment tool was used to evaluate the included research, and the effective data was extracted. The set risk ratio (RR) was calculated with 95% confidence interval (CI), and the rate of CRBSI per 1000 catheter-days and bacterial colonization rate were measured. The primary outcome was CRBSI thousand day rate and the secondary outcome was bacterial colonization rate. The meta analysis was performed by R3.4.1 software. Results Seventeen trials included 4892 patients who received chlorhexidine/sulfadiazine silver coated catheters and conventional standard catheters were included. Compared with conventional standard catheters, chlorhexidine/ silver sulfadiazine catheters were associated with a lower incidence of catheter colonization (RR=0.55, 95%CI: 0.45-0.68, P=0.02). In addition, the the difference of the rate of CRBSI per 1000 catheter-days was not significant (RR=0.70, 95%CI: 0.48-1.02, P=0.32). Conclusion Compared with conventional standard catheters, the use of chlorhexidine/silver sulfadiazine-catheters with bundles can further reduce the incidence of catheter colonization, but does not reduce the rate of CRBSI per 1000 catheter-days.
RESUMEN
The aim of this study was to evaluate the rate of bacterial colonisation and catheter related blood stream infections (CRBSI) together with the antibiotic susceptibility patterns in a tertiary care hospital. CRBSI was detected with semi-quantitative and quantitative methods. The antimicrobial susceptible patterns of the isolated organisms were performed by Kirby Bauer disk diffusion method. The rate of catheter colonisation and CRBSI were 42.1% and 14% (16.1/1000 catheter days) respectively. The most common causative pathogens were Pseudomonas sp. (23.7%), Acinetobacter sp. (18.4%), Staphylococcus aureus (13.2%) and Enterobacteriaceae (10.5%). The rate of isolation of methicillin resistance S. aureus, imipenem resistant Pseudomonas sp. and extended spectrum β lactamase producing Enterobacteriaceae were 60%, 44.0% and 100%. The result of this study would be useful for control and treatment of CRBSI.
RESUMEN
JUSTIFICATIVA E OBJETIVOS: A infecção da corrente sangüínea relacionada à cateter ocorre quando o germe presente no local de inserção atinge a corrente sangüínea, resultando em bacteremia, que quando não contida, provoca infecção com grave comprometimento clínico, podendo resultar em septicemia. Essa infecção a partir do cateter deve ser suspeitada quando não existe um foco infeccioso primário aparente e quando as hemoculturas (do sangue e da ponta do cateter), colhidas após 48h de internação, resultarem no crescimento do mesmo agente infeccioso. O objetivo deste estudo foi revisar as principais recomendações para prevenção, diagnóstico e tratamento das infecções da corrente sangüínea relacionadas à cateteres. CONTEÚDO: Serão apresentadas as atuais recomendações para a prevenção, o diagnóstico e o tratamento das infecções da corrente sangüínea relacionada a cateteres. CONCLUSÕES: Consiste em problema freqüente em centro de terapia intensiva (CTI), contribuindo com a morbimortalidade hospitalar. A elaboração de protocolos para a prevenção e o controle dessas infecções, deve fazer parte da rotina dos CTI.
BACKGROUND AND OBJECTIVES: The catheter related infections occurs when the bacteria of the skin around the catheter reach the blood stream. The catheter related infection is suspected when there is no other evident site of infection and the cultures of the material collected from the catheter and the patientÆs blood show the same agent. CONTENTS: The recommendations of prevention, diagnose and treatment of catheter related infections are presented in this article. CONCLUSIONS: The catheter related infection is a relevant problem in intensive care units (ICU), contributing to a raise in hospital mortality. The elaboration of protocols to prevent and control these infections must be a routine in Intensive Care Unit.