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Octenidine Hydrochloride for the Care of Central Venous Catheter Insertion Sites in Severely Immunocompromised Patients

Published online by Cambridge University Press:  21 June 2016

Andreas Tietz ,
Reno Frei ,
Marc Dangel ,
Dora Bolliger ,
Jakob R. Passweg ,
Alois Gratwohl  and
Andreas F. Widmer
Andreas Tietz
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Reno Frei
Affiliation:
Bacteriology Laboratory, University Hospital Basel, Basel, Switzerland
Marc Dangel
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Dora Bolliger
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Jakob R. Passweg
Affiliation:
Passweg and Gratwohl are from the Division of Hematology, University Hospital Basel, Basel, Switzerland
Alois Gratwohl
Affiliation:
Bacteriology Laboratory, University Hospital Basel, Basel, Switzerland
Andreas F. Widmer*
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
*
Division of Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland, awidmer@uhbs.ch
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Abstract

Objective:

To determine the efficacy and tolerability of octenidine hydrochloride, a non-alcoholic skin antiseptic, for the care of central venous catheter (CVC) insertion sites.

Design:

Prospective, observational study.

Setting:

Bone marrow transplantation unit of a university hospital.

Patients:

All consecutive patients with a nontunneled CVC were enrolled prospectively after informed consent.

Methods:

Octenidine hydrochloride (0.1%) was applied for disinfection at the CVC insertion site during dressing changes. The following cultures were performed weekly as well as at the occurrence of any systemic inflammatory response syndrome criteria: cultures of the skin surrounding the CVC entry site, cultures of the three-way hub connected to the CVC, blood cultures, and cultures of the CVC tip on removal. Enhanced microbiological methods (skin swabs of a 24-cm2 standardized area, roll plate, and sonication of catheter tips) were applied.

Results:

One hundred thirty-five CVCs were inserted in 62 patients during the study period and remained for a mean period of 19.1 days, corresponding to 2,462 catheter-days. Bacterial density at the insertion site declined substantially over time, and most cultures became negative 2 weeks after insertion. Only 6 patients had a documented catheter-related bloodstream infection. The incidence density was 2.39 catheter infections per 1,000 catheter-days. No side effects were noted with application of the antiseptic.

Conclusions:

Disinfection with a skin antiseptic that contains octenidine hydrochloride is highly active and well tolerated. It leads to a decrease in skin colonization over time and may be a new option for CVC care.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 8 , August 2005 , pp. 703 - 707
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Eggimann, P, Pittet, D. Overview of catheter-related infections with special emphasis on prevention based on educational programs. Clin Microbiol Infect 2002;8:295–309.Google Scholar
2.O'Grady, NP, Alexander, M, Dellinger, EP, et al.Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol 2002;23:759–769.CrossRefGoogle ScholarPubMed
3.Harke, HP. Octenidine dihydrochloride: properties of a new antimicrobial agent [in German]. Zentralbl Hyg Umweltmed 1989;188:188–193.Google ScholarPubMed
4.Ellabib, M, Ghannoum, MA, Whittaker, PA. Effects of the pyridinamines octenidine and pirtenidine on yeast mitochondrial function. Biochem Soc Trans 1990;18:342–343.Google Scholar
5.Sedlock, DM, Bailey, DM. Microbicidal activity of octenidine hydrochloride, a new alkanediylbis[pyridine] germicidal agent. Antimicrob Agents Chemother 1985;28:786–790.CrossRefGoogle ScholarPubMed
6.Michel, D, Zach, GAAntiseptic efficacy of disinfecting solutions in suspension test in vitro against methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli in pressure sore wounds after spinal cord injury. Dermatology 1997;195(suppl 2):36–41.Google Scholar
7.Heeg, P. Antisepsis of mucous membranes: current status and aspects of future development [in German]. Z Gesamte Hyg 1990;36:83–86.Google Scholar
8.Werner, HP. The microbicidal efficacy of selected antiseptics [in German]. Hygiene & Medizin 1992;17:51–59.Google Scholar
9.Dettenkofer, M, Jonas, D, Wiechmann, C, et al.Effect of skin disinfection with octenidine dihydrochloride on insertion site colonization of intravascular catheters. Infection 2002;30:282–285.Google Scholar
10.Hughes, WT, Armstrong, D, Bodey, GP, et al.2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730–751.CrossRefGoogle ScholarPubMed
11.Bone, RC, Balk, RA, Cerra, FB, et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644–1655.CrossRefGoogle ScholarPubMed
12.Raad, II, Baba, M, Bodey, GP. Diagnosis of catheter-related infections: the role of surveillance and targeted quantitative skin cultures. Clin Infect Dis 1995;20:593–597.Google Scholar
13.Sherertz, RJ, Heard, SO, Raad, II. Diagnosis of triple-lumen catheter infection: comparison of roll plate, sonication, and flushing methodologies. J Clin Microbiol 1997;35:641–646.CrossRefGoogle ScholarPubMed
14.Maki, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 1977;296:1305–1309.CrossRefGoogle ScholarPubMed
15.Trampuz, A, Lederrey, N, Widmer, AF. Compliance with hand hygiene 25 years after introduction of hand rub. Presented at the 41st Inter-science Conference on Antimicrobial Agents and Chemotherapy; December 12-16, 2001; Chicago, IL. Abstract K-1335.Google Scholar
16.Dettenkofer, M, Ebner, W, Bertz, H, et al.Surveillance of nosocomial infections in adult recipients of allogeneic and autologous bone marrow and peripheral blood stem-cell transplantation. Bone Marrow Transplant 2003;31:795–801.CrossRefGoogle ScholarPubMed