ABSTRACT
Objetivo: Evaluar la eficacia de la higiene diaria con esponjas impregnadas con clorhexidina al 4% para disminuir la contaminación de hemocultivos en pacientes ingresados en UCI. Material y método: Estudio prospectivo, cuasi experimental, longitudinal, unicéntrico. Durante 24 meses (de abril de 2013 a marzo de 2015) fueron analizados 237 pacientes que cumplieron los criterios de inclusión, y fueron divididos en 2 grupos: uno recibió higiene corporal diaria con jabón común (grupo control, n= 118) y el otro con clorhexidina (grupo intervención, n= 119). Fueron incluidas variables demográficas, tipo de enfermedad, nivel de gravedad, estancia y mortalidad en UCI y hospitalaria, y tiempo trascurrido (minutos) desde el baño hasta la extracción de los hemocultivos. Resultados: El análisis estadístico mostró una mayor proporción de contaminación de los hemocultivos durante el período control con respecto al de intervención (15,5 vs. 6,3%); con una diferencia significativa: 9,23% (IC 95%: 1,34-16,7%), odds ratio de 2,73 (IC 95%: 1,13-6,63). El análisis de supervivencia mostró una menor probabilidad de contaminación de los hemocultivos hasta las 18 h desde el baño. El baño sin clorhexidina aumentó el riesgo de contaminación de los hemocultivos (HR: 3,05; IC 95%: 1,14-8,12). Conclusiones: El empleo de jabón con clorhexidina al 4% en la higiene diaria de los pacientes críticos disminuyó la incidencia de contaminaciones de hemocultivos y su efecto perduró al menos 18 h (AU)
Objective: To evaluate the efficacy of daily cleaning with 4% chlorhexidine-impregnated sponges in decreasing contamination of blood cultures in critically-ill patients. Material and methods: Prospective, quasi-experimental, longitudinal, single-centre trial. During 24 months (April 2013 to March 2015), we analysed 237 patients who fulfilled the inclusion criteria, divided into 2 groups: one underwent daily cleaning with common soap (control group, n= 108), and the other with chlorhexidine (intervention group, n= 109). Demographic variables, pathology group, severity scores, ICU and hospital length of stay and mortality, and time passed since cleaning to blood culture extraction were included. Results: Statistical analysis showed a higher proportion of contaminated blood cultures during the control group period in contrast with the intervention group period (15 vs. 6.3%), with a significant difference: 9.23% (CI95%: 1,34-16,7%), with an odds ratio of 2,73 (CI95%: 1,13-6,63). Surveillance analysis showed lower probability of blood culture contamination within the 18 hours following daily cleaning. Cleaning without chlorhexidine increased contamination of blood cultures (HR: 3,05; CI95%: 1,14-8,12). Conclusions: The use of 4% chlorhexidine-impregnated sponges for daily cleaning of critically-ill patients decreases blood culture contamination incidence and its protection lasts for almost 18h (AU)
Subject(s)
Humans , Chlorhexidine/therapeutic use , Critical Care/methods , Cross Infection/prevention & control , Intensive Care Units/standards , Prospective Studies , Blood Specimen Collection/standards , Soaps/therapeutic useABSTRACT
OBJECTIVE: To evaluate the efficacy of daily cleaning with 4% chlorhexidine-impregnated sponges in decreasing contamination of blood cultures in critically-ill patients. MATERIAL AND METHODS: Prospective, quasi-experimental, longitudinal, single-centre trial. During 24 months (April 2013 to March 2015), we analysed 237 patients who fulfilled the inclusion criteria, divided into 2groups: one underwent daily cleaning with common soap (control group, n= 108), and the other with chlorhexidine (intervention group, n= 109). Demographic variables, pathology group, severity scores, ICU and hospital length of stay and mortality, and time passed since cleaning to blood culture extraction were included. RESULTS: Statistical analysis showed a higher proportion of contaminated blood cultures during the control group period in contrast with the intervention group period (15 vs. 6.3%), with a significant difference: 9.23% (CI95%: 1,34-16,7%), with an odds ratio of 2,73 (CI95%: 1,13-6,63). Surveillance analysis showed lower probability of blood culture contamination within the 18hours following daily cleaning. Cleaning without chlorhexidine increased contamination of blood cultures (HR: 3,05; CI95%: 1,14-8,12). CONCLUSIONS: The use of 4% chlorhexidine-impregnated sponges for daily cleaning of critically-ill patients decreases blood culture contamination incidence and its protection lasts for almost 18h.
Subject(s)
Anti-Infective Agents, Local/administration & dosage , Baths , Blood Culture , Blood/microbiology , Chlorhexidine/administration & dosage , Critical Illness , Hygiene , Aged , Bacteria/isolation & purification , Decontamination/methods , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Skin/microbiology , SoapsABSTRACT
This study was performed in order to determine the relative and combined effects of ethanol, a low protein diet and steroid treatment on bone, muscle, liver, and urinary and faecal excretion of zinc, copper and iron in 64 rats divided into eight groups treated following the Lieber-DeCarli liquid diet technique, with and without dexamethasone, 1 mg/l. Steroids showed a lack of effect on liver zinc, but enhanced ethanol- and low protein-mediated liver iron overload when both factors were combined. Steroids also increased muscle copper, iron and zinc, and bone copper, especially in the low protein, ethanol-fed rats.
