title: A randomized trial on chlorhexidine dressings for the prevention of catheter-related bloodstream infections in neutropenic patients.
abstract: Central venous catheter (CVC)-related bloodstream infections (CRBSI) are a frequent cause of morbidity and mortality in patients with chemotherapy-induced neutropenia. Chlorhexidine containing catheter securement dressings may prevent CRBSI.
  
  
  
  A multicenter randomized, controlled trial was conducted at 10 German hematology departments. We compared chlorhexidine-containing dressings with non-chlorhexidine control dressings in neutropenic patients. The primary end point was the incidence of definite CRBSI within the first 14 days (dCRBSI14) of CVC placement. Secondary end points included combined incidence of definite or probable CRBSI within 14 days (dpCRBSI14), overall (dpCRBSI), incidence of unscheduled dressing changes and adverse events.
  
  
  
  From February 2012 to September 2014, 613 assessable patients were included in the study. The incidence of dCRBSI14 was 2.6% (8/307) in the chlorhexidine and 3.9% (12/306) in the control group (P = 0.375). Both dpCRBSI14 and dpCRBSI were significantly less frequent in the study group with dpCRBSI14 in 6.5% (20/307) of the chlorhexidine group when compared with 11% (34/306) in the control group (P = 0.047), and dpCRBSI in 10.4% (32/307) versus 17% (52/306), respectively (P = 0.019). The frequency of dressing intolerance with cutaneous and soft tissue abnormalities at the contact area was similar in both groups (12.4% and 11.8%; P = 0.901).
  
  
  
  Although the trial failed its primary end point, the application of chlorhexidine containing catheter securement dressings reduces the incidence of definite or probable CRBSI in neutropenic patients.
  
  
  
  NCT01544686 (Clinicaltrials.gov).
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne German Center for Infection Research (DZIF), partner site Bonn-Cologne, Cologne.
authors.forename: L M
authors.initials: LM
authors.lastname: Biehl
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne.
authors.forename: A
authors.initials: A
authors.lastname: Huth
authors.affiliation: Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University Hospital, Aachen.
authors.forename: J
authors.initials: J
authors.lastname: Panse
authors.affiliation: Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University Hospital, Aachen.
authors.forename: C
authors.initials: C
authors.lastname: Krämer
authors.affiliation: Department of Medicine III, Red Cross Hospital, Munich.
authors.forename: M
authors.initials: M
authors.lastname: Hentrich
authors.affiliation: Department of Medicine I, Hematology, Oncology and Stem Cell Transplantation, University of Freiburg Medical Center, Freiburg im Breisgau.
authors.forename: M
authors.initials: M
authors.lastname: Engelhardt
authors.affiliation: Medical Clinic 5, Hematology and Oncology, Klinikum Nuernberg, Nuernberg.
authors.forename: K
authors.initials: K
authors.lastname: Schäfer-Eckart
authors.affiliation: Charitè University Medicine, Department of Medicine, Division of Oncology/ Hematology, Charitè Campus Mitte, Berlin.
authors.forename: G
authors.initials: G
authors.lastname: Kofla
authors.affiliation: Medical Clinic I, Hematology and Medical Oncology, Hemostaseology, Clinical Center Frankfurt/Oder, Frankfurt/Oder.
authors.forename: M
authors.initials: M
authors.lastname: Kiehl
authors.affiliation: Department of Hematology, Oncology, Immunology, Palliative Care, Infectious Diseases and Tropical Medicine, Klinikum Schwabing, Munich.
authors.forename: C-M
authors.initials: CM
authors.lastname: Wendtner
authors.affiliation: Department of Hematology and Oncology, Klinikum Neuperlach and Klinikum Harlaching, Munich.
authors.forename: M
authors.initials: M
authors.lastname: Karthaus
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine II, University Hospital Wuerzburg, Wuerzburg.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ullmann
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hellmich
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Christ
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne German Center for Infection Research (DZIF), partner site Bonn-Cologne, Cologne maria.vehreschild@uk-koeln.de.
authors.forename: M J G T
authors.initials: MJ
authors.lastname: Vehreschild
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D055499:Catheter-Related Infections / Q000150:complications / Q000473:pathology / Q000517:prevention & control*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002710:Chlorhexidine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology
chemical_list: D002710:Chlorhexidine
keywords: catheter dressings; catheter-related bloodstream infections; chlorhexidine; neutropenia