Effect of skin disinfection with octenidine dihydrochloride on insertion site colonization of intravascular catheters.
BACKGROUND
We investigated the efficacy of two commercially available, alcohol-based antiseptic solutions in decontaminating the insertion site of central lines. One solution contained the bispyridine octenidine dihydrochloride.


METHODS
Inpatients receiving either a central venous catheter (CVC) or a peripherally inserted central catheter (PICC) were alternately assigned to different skin disinfection regimens at the insertion site: (A) 0.1% octendine dihydrochloride with 30% 1-propanol and 45% 2-propanol, (B) 74% ethanol with 10% 2-propanol. Quantitative skin cultures were obtained from the insertion site at predetermined intervals.


RESULTS
A total of 60 patients received 12 CVCs and 47 PICCs (no significant difference with respect to gender, age and catheter type). In total, 90 cultures were assessed in each group. The median colony-forming unit (cfu) counts per 24 cm(2) (group A vs B) were 2,270 vs 2,950 before, 20 vs 40 following and 860 vs 1,210 24 h after catheter insertion, respectively. A statistically significant difference in the efficacy of skin decontamination was seen between groups in culture set (3) and in the difference between culture sets (2) and (3) (Wilcoxon rank sum test).


CONCLUSIONS
Octenidine/propanol appears to be more effective than alcohol (ethanol/propanol) alone in reducing microflora of the skin at the PICC/CVC insertion site over a 24-h period.
Dettenkofer
M
M
Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Hugstetter Str. 55, D-79106 Freiburg, Germany. mdet@iuk3.ukl.uni-freiburg.de
Jonas
D
D
Wiechmann
C
C
Rossner
R
R
Frank
U
U
Zentner
J
J
Daschner
F D
FD
D000433:1-Propanol / Q000494:pharmacology*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001424:Bacterial Infections / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000379:methods; D002406:Catheterization, Peripheral / Q000379:methods; D004203:Disinfection / Q000379:methods*; D004359:Drug Therapy, Combination; D004866:Equipment Contamination / Q000517:prevention & control*; D000431:Ethanol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007097:Imines; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D011725:Pyridines / Q000494:pharmacology*; D012680:Sensitivity and Specificity; D012867:Skin / Q000187:drug effects / Q000382:microbiology; D018709:Statistics, Nonparametric
D000891:Anti-Infective Agents, Local; D007097:Imines; D011725:Pyridines; D000431:Ethanol; D000433:1-Propanol; C034213:octenidine