Uso de clorhexidina y su papel preventivo en las infecciones del torrente sanguíneo asociadas a catéteres en los recién nacidos: revisión de tema

  • Lina M. Castaño-Jaramillo Universidad CES
  • Carolina Henao-Ochoa Universidad CES
  • Ana C. Osorio-Vásquez Universidad CES
Palabras clave: infección hospitalaria, infecciones relacionadas con catéteres, clorhexidina, recién nacido.

Resumen

Las infecciones asociadas al cuidado de la salud representan un problema de salud pública y son un indicador de la calidad en prestación y gestión en salud. Es por esto que ha sido necesaria la creación de programas de vigilancia y control epidemiológico, y la adaptación e implementación de guías para su prevención. Estas estrategias mejoran la seguridad del paciente y deben ser una prioridad para las instituciones. En este contexto, la infección asociada a catéter es la más común de las infecciones asociadas al cuidado de la salud, principalmente en la población pediátrica, siendo los neonatos los más susceptibles a causa de la inmadurez de sus barreras primarias y sistema inmunológico, y a la alta frecuencia de procedimientos invasivos como los accesos vasculares para la administración de medicamentos o la nutrición parenteral. Actualmente existen múltiples medidas para prevenir dichas infecciones en pediatría y la tendencia es crear estrategias bien estructuradas para facilitar su aplicación. La higiene de manos continúa siendo un pilar fundamental dentro de todos los protocolos para disminuir las tasas de infección asociadas al cuidado de la salud; sin embargo, se requiere de nuevas estrategias para la prevención de las mismas, como el uso de la clorhexidina como antiséptico tópico previo a la inserción de dispositivos intravasculares y el aseo rutinario en pacientes con catéteres centrales, lo cual es el objeto de revisión de este manuscrito.

 

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Biografía del autor/a

Lina M. Castaño-Jaramillo, Universidad CES

Médica, residente de Pediatría, Universidad CES. Medellín, Colombia.

Carolina Henao-Ochoa, Universidad CES

Médica, residente de Pediatría, Universidad CES. Medellín, Colombia.

Ana C. Osorio-Vásquez, Universidad CES

Médica, residente de Pediatría, Universidad CES. Medellín, Colombia.

Referencias bibliográficas

Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010; 31: 319-326.

https://doi.org/10.1086/651091

Fisher D, Cochran KM, Provost LP, Patterson J, Bristol T, Metzguer K, et al. Reducing central line-associated bloodstream infections in North Carolina NICUs. Pediatrics 2013; 132: e1664-1671.

https://doi.org/10.1542/peds.2013-2000

Milstone AM, Reich NG, Advani S, Yuan G, Bryant K, Coffin SE, et al. Catheter dwell time and CLABSIs in neonates with PICCs: a multicenter cohort study. Pediatrics 2013; 132: e1609-1615.

https://doi.org/10.1542/peds.2013-1645

Centers for Disease Control and Prevention (CDC). Vital signs: central line-associated blood stream infections--United States, 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep 2011; 60: 243-248.

Centers for Disease Control and Prevention (CDC). National and State Healthcare-Associated Infections Progress Report. Atlanta, Estados Unidos: National Center for Emerging and Zoonotic Infectious Diseases. 2015. Disponible: http://www.cdc.gov/HAI/pdfs/progress-report/hai-progress-report-2015.pdf. Consultado: abr 2015.

Fanaroff AA, Hack M, Walsh MC. The NICHD neonatal research network: changes in practice and outcomes during the first 15 years. Semin Perinatol 2003; 27: 281-287.

https://doi.org/10.1016/S0146-0005(03)00055-7

Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ. Nosocomial infections among neonates in high-risk nurseries in the United States. National Nosocomial Infections Surveillance System. Pediatrics 1996; 98: 357-361.

Centers for Disease Control and Prevention (CDC). The National Healthcare Safety Network (NHSN) Manual: Patient safety component protocol. Atlanta, Estados Unidos: Division of Healthcare Quality Promotion, National Center for Infectious Diseases. 2008. Disponible: http://www.dhcs.ca.gov/provgovpart/initiatives/nqi/Documents/NHSNManPSPCurr.pdf. Consultado: abr 2015.

Stone PW. Economic burden of healthcare-associated infections: an American perspective. Expert Rev Pharmacoecon Outcomes Res 2009; 9: 417-422.

https://doi.org/10.1586/erp.09.53

Centers for Disease Control (CDC). Public health focus: surveillance, prevention, and control of nosocomial infections. MMWR Morb Mortal Wkly Rep 1992; 41: 783-787.

Díaz Guio DA, Montoya Navarrete F. Prevención de la infección nosocomial en UCI. Acta Colomb Cuid Intensivo 2011; 11: 68-75.

Becerra MR, Tantalean JA, Suarez VJ, Alvarado MC, Candela JL, Urcia FC. Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country. BMC Pediatr 2010; 10: 66.

https://doi.org/10.1186/1471-2431-10-66

van der Zwet WC, Kaiser AM, van Elburg RM, Berkhof J, Fetter WP, Parlevliet GA, et al. Nosocomial infections in a Dutch neonatal intensive care unit: surveillance study with definitions for infection specifically adapted for neonates. J Hosp Infect 2005; 61: 300-311.

https://doi.org/10.1016/j.jhin.2005.03.014

Johann DA, De Lazzari LS, Pedrolo E, Mingorance P, de Almeida TQ, Danski MT. [Peripherally inserted central catheter care in neonates: an integrative literature review]. Rev Esc Enferm USP 2012; 46: 1503-1511.

https://doi.org/10.1590/S0080-62342012000600030

Johnson TJ, Patel AL, Jegier BJ, Engstrom JL, Meier PP. Cost of morbidities in very low birth weight infants. J Pediatr 2013; 162: 243-249 e241.

https://doi.org/10.1016/j.jpeds.2012.07.013

Parker LA, Krueger C, Sullivan S, Kelechi T, Mueller M. Effect of breast milk on hospital costs and length of stay among very low-birth-weight infants in the NICU. Adv Neonatal Care 2012; 12: 254-259.

https://doi.org/10.1097/ANC.0b013e318260921a

Edwards JR, Peterson KD, Mu Y, Banerjee S, Allen-Bridson K, Morrell G, et al. National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009. Am J Infect Control 2009; 37: 783-805.

https://doi.org/10.1016/j.ajic.2009.10.001

Dudeck MA, Horan TC, Peterson KD, Allen-Bridson K, Morrell G, Anttila A, et al. National Healthcare Safety Network report, data summary for 2011, device-associated module. Am J Infect Control 2013; 41: 286-300.

https://doi.org/10.1016/j.ajic.2013.01.002

Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet 2005; 365: 891-900.

https://doi.org/10.1016/S0140-6736(05)71048-5

Alkiaat A, Hutchinson M, Jacques A, Sharp MJ, Dickinson JE. Evaluation of the frequency and obstetric risk factors associated with term neonatal admissions to special care units. Aust N Z J Obstet Gynaecol 2013; 53: 277-282.

https://doi.org/10.1111/ajo.12070

Brodie SB, Sands KE, Gray JE, Parker RA, Goldmann DA, Davis RB, et al. Occurrence of nosocomial bloodstream infections in six neonatal intensive care units. Pediatr Infect Dis J 2000; 19: 56-65.

https://doi.org/10.1097/00006454-200001000-00012

Quach C, Milstone AM, Perpete C, Bonenfant M, Moore DL, Perreault T. Chlorhexidine bathing in a tertiary care neonatal intensive care unit: impact on central line-associated bloodstream infections. Infect Control Hosp Epidemiol 2014; 35: 158-163.

https://doi.org/10.1086/674862

Krause PJ, Herson VC, Boutin-Lebowitz J, Eisenfeld L, Block C, LoBello T, et al. Polymorphonuclear leukocyte adherence and chemotaxis in stressed and healthy neonates. Pediatr Res 1986; 20: 296-300.

https://doi.org/10.1203/00006450-198604000-00004

Martínez R, Sanchez R, Villanueva Y, Gallón C. Utilidad del catéter central de acceso periférico (PICC) en recién nacidos prematuros de la unidad de cuidado intensivo neonatal de la Clínica General del Norte. Rev Colomb Enferm 2012; 7: 22-30.

https://doi.org/10.18270/rce.v7i7.1444

Ainsworth SB, Clerihew L, McGuire W. Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates. Cochrane Database Syst Rev 2007: CD004219.

https://doi.org/10.1002/14651858.CD004219.pub3

McCay AS, Elliott EC, Walden M. Videos in clinical medicine. PICC placement in the neonate. N Engl J Med 2014; 370: e17.

https://doi.org/10.1056/NEJMvcm1101914

Ozkiraz S, Gokmen Z, Anuk Ince D, Akcan AB, Kilicdag H, Ozel D, et al. Peripherally inserted central venous catheters in critically ill premature neonates. J Vasc Access 2013; 14: 320-324.

https://doi.org/10.5301/jva.5000157

Arnts IJ, Bullens LM, Groenewoud JM, Liem KD. Comparison of complication rates between umbilical and peripherally inserted central venous catheters in newborns. J Obstet Gynecol Neonatal Nurs 2014; 43: 205-215.

https://doi.org/10.1111/1552-6909.12278

Butler-O'Hara M, D'Angio CT, Hoey H, Stevens TP. An evidence-based catheter bundle alters central venous catheter strategy in newborn infants. J Pediatr 2012; 160: 972-977 e972.

https://doi.org/10.1016/j.jpeds.2011.12.004

Yang ZM, Wang SN, Ma YL, Yang XL, Zhang WY, Zhu MY. [Application of umbilical venous catheter combined with peripherally inserted central catheter in very low birth weight infants]. Zhongguo Dang Dai Er Ke Za Zhi 2013; 15: 353-355.

Ohki Y, Maruyama K, Harigaya A, Kohno M, Arakawa H. Complications of peripherally inserted central venous catheter in Japanese neonatal intensive care units. Pediatr Int 2013; 55: 185-189.

https://doi.org/10.1111/ped.12033

Duarte ED, Pimenta AM, e Silva BC, de Paula CM. [Factors associated with infection from the use of peripherally inserted central catheters in a neonatal intensive care unit]. Rev Esc Enferm USP 2013; 47: 547-554.

https://doi.org/10.1590/S0080-623420130000300004

Jumani K, Advani S, Reich NG, Gosey L, Milstone AM. Risk factors for peripherally inserted central venous catheter complications in children. JAMA Pediatr 2013; 167: 429-435.

https://doi.org/10.1001/jamapediatrics.2013.775

Sengupta A, Lehmann C, Diener-West M, Perl TM, Milstone AM. Catheter duration and risk of CLA-BSI in neonates with PICCs. Pediatrics 2010; 125: 648-653.

https://doi.org/10.1542/peds.2009-2559

Panagiotounakou P, Antonogeorgos G, Gounari E, Papadakis S, Labadaridis J, Gounaris AK. Peripherally inserted central venous catheters: frequency of complications in premature newborn depends on the insertion site. J Perinatol 2014; 34: 461-463.

https://doi.org/10.1038/jp.2014.36

Corzine M, Willett LD. Neonatal PICC: one unit's six-year experience with limiting catheter complications. Neonatal Netw 2010; 29: 161-173.

https://doi.org/10.1891/0730-0832.29.3.161

Wrightson DD. Peripherally inserted central catheter complications in neonates with upper versus lower extremity insertion sites. Adv Neonatal Care 2013; 13: 198-204.

https://doi.org/10.1097/ANC.0b013e31827e1d01

Bulbul A, Okan F, Nuhoglu A. Percutaneously inserted central catheters in the newborns: a center's experience in Turkey. J Matern Fetal Neonatal Med 2010; 23: 529-535.

https://doi.org/10.3109/14767050903214582

Polin RA, Saiman L. Nosocomial Infections in the Neonatal Intensive Care Unit. NeoReviews 2003; 4: e81-e89.

https://doi.org/10.1542/neo.4-3-e81

Helwich E, Wojkowska-Mach J, Borszewska-Kornacka M, Gadzinowski J, Gulczynska E, Kordek A, et al. [Epidemiology of infections in very low birth weight infants. Polish Neonatology Network research]. Med Wieku Rozwoj 2013; 17: 224-231.

Polin RA, Denson S, Brady MT. Epidemiology and diagnosis of health care-associated infections in the NICU. Pediatrics 2012; 129: e1104-1109.

https://doi.org/10.1542/peds.2012-0147

Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH, et al. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr 2001; 139: 821-827.

https://doi.org/10.1067/mpd.2001.119442

Garland JS, Alex CP, Sevallius JM, Murphy DM, Good MJ, Volberding AM, et al. Cohort study of the pathogenesis and molecular epidemiology of catheter-related bloodstream infection in neonates with peripherally inserted central venous catheters. Infect Control Hosp Epidemiol 2008; 29: 243-249.

https://doi.org/10.1086/526439

Yu Y, Du L, Yuan T, Zheng J, Chen A, Chen L, et al. Risk factors and clinical analysis for invasive fungal infection in neonatal intensive care unit patients. Am J Perinatol 2013; 30: 589-594.

https://doi.org/10.1055/s-0032-1329688

Benjamin DK, Jr., Ross K, McKinney RE, Jr., Benjamin DK, Auten R, Fisher RG. When to suspect fungal infection in neonates: A clinical comparison of Candida albicans and Candida parapsilosis fungemia with coagulase-negative staphylococcal bacteremia. Pediatrics 2000; 106: 712-718.

https://doi.org/10.1542/peds.106.4.712

Saiman L, Ludington E, Pfaller M, Rangel-Frausto S, Wiblin RT, Dawson J, et al. Risk factors for candidemia in Neonatal Intensive Care Unit patients. The National Epidemiology of Mycosis Survey study group. Pediatr Infect Dis J 2000; 19: 319-324.

https://doi.org/10.1097/00006454-200004000-00011

Linares J, Sitges-Serra A, Garau J, Perez JL, Martin R. Pathogenesis of catheter sepsis: a prospective study with quantitative and semiquantitative cultures of catheter hub and segments. J Clin Microbiol 1985; 21: 357-360.

Klein JF, Shahrivar F. Use of percutaneous silastic central venous catheters in neonates and the management of infectious complications. Am J Perinatol 1992; 9: 261-264.

https://doi.org/10.1055/s-2007-994785

Boutaric E, Gilardi M, Cecile W, Flechelles O. [Impact of clinical practice guidelines on the incidence of bloodstream infections related to peripherally inserted central venous catheter in preterm infants]. Arch Pediatr 2013; 20: 130-136.

https://doi.org/10.1016/j.arcped.2012.11.001

Garland JS, Uhing MR. Strategies to prevent bacterial and fungal infection in the neonatal intensive care unit. Clin Perinatol 2009; 36: 1-13.

https://doi.org/10.1016/j.clp.2008.09.005

Jeong IS, Park SM, Lee JM, Song JY, Lee SJ. Effect of central line bundle on central line-associated bloodstream infections in intensive care units. Am J Infect Control 2013; 41: 710-716.

https://doi.org/10.1016/j.ajic.2012.10.010

Graham PL, 3rd. Simple strategies to reduce healthcare associated infections in the neonatal intensive care unit: line, tube, and hand hygiene. Clin Perinatol 2010; 37: 645-653.

https://doi.org/10.1016/j.clp.2010.06.005

Ceballos K, Waterman K, Hulett T, Makic MB. Nurse-driven quality improvement interventions to reduce hospital-acquired infection in the NICU. Adv Neonatal Care 2013; 13: 154-163; quiz 164-155.

https://doi.org/10.1097/ANC.0b013e318285fe70

Bizzarro MJ, Sabo B, Noonan M, Bonfiglio MP, Northrup V, Diefenbach K. A quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2010; 31: 241-248.

https://doi.org/10.1086/650448

Tamma PD, Aucott SW, Milstone AM. Chlorhexidine use in the neonatal intensive care unit: results from a national survey. Infect Control Hosp Epidemiol 2010; 31: 846-849.

https://doi.org/10.1086/655017

Darmstadt GL, Hossain MM, Choi Y, Shirin M, Mullany LC, Islam M, et al. Safety and effect of chlorhexidine skin cleansing on skin flora of neonates in Bangladesh. Pediatr Infect Dis J 2007; 26: 492-495.

https://doi.org/10.1097/01.inf.0000261927.90189.88

O'Donnell JA, Gelone SP. Topical Antibacterials. En: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Vol. 1 (ed 7ma). Filadelfia, Estados Unidos: Churchill Livingstone, Elsevier; 2010: 521-532.

https://doi.org/10.1016/B978-0-443-06839-3.00038-2

Hibbard JS, Mulberry GK, Brady AR. A clinical study comparing the skin antisepsis and safety of ChloraPrep, 70% isopropyl alcohol, and 2% aqueous chlorhexidine. J Infus Nurs 2002; 25: 244-249.

https://doi.org/10.1097/00129804-200207000-00007

U.S. Food and Drug Administration. FDA Approved Drug Products. Maryland, Estados Unidos. Disponible: http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.SearchAction&SearchType=BasicSearch&SearchTerm=CHLORHEXIDINE. Consultado: abr 2014.

Sharpe E, Pettit J, Ellsbury DL. A national survey of neonatal peripherally inserted central catheter (PICC) practices. Adv Neonatal Care 2013; 13: 55-74.

https://doi.org/10.1097/ANC.0b013e318278b907

Upadhyayula S, Kambalapalli M, Harrison CJ. Safety of anti-infective agents for skin preparation in premature infants. Arch Dis Child 2007; 92: 646-647.

https://doi.org/10.1136/adc.2007.117002

Suresh GK, Edwards WH. Central line-associated bloodstream infections in neonatal intensive care: changing the mental model from inevitability to preventability. Am J Perinatol 2012; 29: 57-64.

https://doi.org/10.1055/s-0031-1286182

Sannoh S, Clones B, Munoz J, Montecalvo M, Parvez B. A multimodal approach to central venous catheter hub care can decrease catheter-related bloodstream infection. Am J Infect Control 2010; 38: 424-429.

https://doi.org/10.1016/j.ajic.2009.07.014

Curry S, Honeycutt M, Goins G, Gilliam C. Catheter-associated bloodstream infections in the NICU: getting to zero. Neonatal Netw 2009; 28: 151-155.

https://doi.org/10.1891/0730-0832.28.3.151

Da Cunha ML, Procianoy RS, Franceschini DT, De Oliveira LL, Cunha ML. Effect of the first bath with chlorhexidine on skin colonization with Staphylococcus aureus in normal healthy term newborns. Scand J Infect Dis 2008; 40: 615-620.

https://doi.org/10.1080/00365540801932447

Mullany LC, Khatry SK, Sherchand JB, LeClerq SC, Darmstadt GL, Katz J, et al. A randomized controlled trial of the impact of chlorhexidine skin cleansing on bacterial colonization of hospital-born infants in Nepal. Pediatr Infect Dis J 2008; 27: 505-511.

https://doi.org/10.1097/INF.0b013e31816791a2

Rosenthal VD. Central line-associated bloodstream infections in limited-resource countries: a review of the literature. Clin Infect Dis 2009; 49: 1899-1907.

https://doi.org/10.1086/648439

Taha TE, Biggar RJ, Broadhead RL, Mtimavalye LA, Justesen AB, Liomba GN, et al. Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: clinical trial. BMJ 1997; 315: 216-219; discussion 220.

https://doi.org/10.1136/bmj.315.7102.216

Tielsch JM, Darmstadt GL, Mullany LC, Khatry SK, Katz J, LeClerq SC, et al. Impact of newborn skin-cleansing with chlorhexidine on neonatal mortality in southern Nepal: a community-based, cluster-randomized trial. Pediatrics 2007; 119: e330-340.

https://doi.org/10.1542/peds.2006-1192

Nuntnarumit P, Sangsuksawang N. A randomized controlled trial of 1% aqueous chlorhexidine gluconate compared with 10% povidone-iodine for topical antiseptic in neonates: effects on blood culture contamination rates. Infect Control Hosp Epidemiol 2013; 34: 430-432.

https://doi.org/10.1086/669863

Atahan K, Cokmez A, Bekoglu M, Durak E, Tavusbay C, Tarcan E. The effect of antiseptic solution in central venous catheter care. Bratisl Lek Listy 2012; 113: 548-551.

https://doi.org/10.4149/BLL_2012_123

Chaiyakunapruk N, Veenstra DL, Lipsky BA, Saint S. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis. Ann Intern Med 2002; 136: 792-801.

https://doi.org/10.7326/0003-4819-136-11-200206040-00007

Garland JS, Alex CP, Mueller CD, Otten D, Shivpuri C, Harris MC, et al. A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001; 107: 1431-1436.

https://doi.org/10.1542/peds.107.6.1431

Pereira L, Chipato T, Mashu A, Mushangwe V, Rusakaniko S, Bangdiwala SI, et al. Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine. Int J Gynaecol Obstet 2011; 112: 234-238.

https://doi.org/10.1016/j.ijgo.2010.09.009

Wilson CM, Gray G, Read JS, Mwatha A, Lala S, Johnson S, et al. Tolerance and safety of different concentrations of chlorhexidine for peripartum vaginal and infant washes: HIVNET 025. J Acquir Immune Defic Syndr 2004; 35: 138-143.

https://doi.org/10.1097/00126334-200402010-00006

Garland JS, Alex CP, Uhing MR, Peterside IE, Rentz A, Harris MC. Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates. J Perinatol 2009; 29: 808-813.

https://doi.org/10.1038/jp.2009.161

Reynolds PR, Banerjee S, Meek JH. Alcohol burns in extremely low birthweight infants: still occurring. Arch Dis Child Fetal Neonatal Ed 2005; 90: F10.

https://doi.org/10.1136/adc.2004.054338

Lashkari HP, Chow P, Godambe S. Aqueous 2% chlorhexidine-induced chemical burns in an extremely premature infant. Arch Dis Child Fetal Neonatal Ed 2012; 97: F64.

https://doi.org/10.1136/adc.2011.215145

Climo MW, Yokoe DS, Warren DK, Perl TM, Bolon M, Herwaldt LA, et al. Effect of daily chlorhexidine bathing on hospital-acquired infection. N Engl J Med 2013; 368: 533-542.

https://doi.org/10.1056/NEJMoa1113849

O'Horo JC, Silva GL, Munoz-Price LS, Safdar N. The efficacy of daily bathing with chlorhexidine for reducing healthcare-associated bloodstream infections: a meta-analysis. Infect Control Hosp Epidemiol 2012; 33: 257-267.

https://doi.org/10.1086/664496

Viray MA, Morley JC, Coopersmith CM, Kollef MH, Fraser VJ, Warren DK. Daily bathing with chlorhexidine-based soap and the prevention of Staphylococcus aureus transmission and infection. Infect Control Hosp Epidemiol 2014; 35: 243-250.

https://doi.org/10.1086/675292

Maki DG, Ringer M, Alvarado CJ. Prospective randomised trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 1991; 338: 339-343.

https://doi.org/10.1016/0140-6736(91)90479-9

Valles J, Fernandez I, Alcaraz D, Chacon E, Cazorla A, Canals M, et al. Prospective randomized trial of 3 antiseptic solutions for prevention of catheter colonization in an intensive care unit for adult patients. Infect Control Hosp Epidemiol 2008; 29: 847-853.

https://doi.org/10.1086/590259

Rupp ME, Lisco SJ, Lipsett PA, Perl TM, Keating K, Civetta JM, et al. Effect of a second-generation venous catheter impregnated with chlorhexidine and silver sulfadiazine on central catheter-related infections: a randomized, controlled trial. Ann Intern Med 2005; 143: 570-580.

https://doi.org/10.7326/0003-4819-143-8-200510180-00007

Small H, Adams D, Casey AL, Crosby CT, Lambert PA, Elliott T. Efficacy of adding 2% (w/v) chlorhexidine gluconate to 70% (v/v) isopropyl alcohol for skin disinfection prior to peripheral venous cannulation. Infect Control Hosp Epidemiol 2008; 29: 963-965.

https://doi.org/10.1086/590664

Karpanen TJ, Casey AL, Conway BR, Lambert PA, Elliott TS. Antimicrobial activity of a chlorhexidine intravascular catheter site gel dressing. J Antimicrob Chemother 2011; 66: 1777-1784.

https://doi.org/10.1093/jac/dkr191

Munoz-Price LS, Hota B, Stemer A, Weinstein RA. Prevention of bloodstream infections by use of daily chlorhexidine baths for patients at a long-term acute care hospital. Infect Control Hosp Epidemiol 2009; 30: 1031-1035.

https://doi.org/10.1086/644751

Popovich KJ, Hota B, Hayes R, Weinstein RA, Hayden MK. Effectiveness of routine patient cleansing with chlorhexidine gluconate for infection prevention in the medical intensive care unit. Infect Control Hosp Epidemiol 2009; 30: 959-963.

https://doi.org/10.1086/605925

Chaiyakunapruk N, Veenstra DL, Lipsky BA, Sullivan SD, Saint S. Vascular catheter site care: the clinical and economic benefits of chlorhexidine gluconate compared with povidone iodine. Clin Infect Dis 2003; 37: 764-771.

https://doi.org/10.1086/377265

O'Grady N P, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control 2002; 30: 476-489.

https://doi.org/10.1067/mic.2002.129427

Álvarez CA, Cortés JA, Gómez CH, Fernández JA, Sossa MP, Beltrán F, et al. Guías de práctica clínica para la prevención de infecciones intrahospitalarias asociadas al uso de dispositivos médicos. Infectio 2010; 14: 292-308.

https://doi.org/10.1016/S0123-9392(10)70123-5

Cómo citar
1.
Castaño-Jaramillo LM, Henao-Ochoa C, Osorio-Vásquez AC. Uso de clorhexidina y su papel preventivo en las infecciones del torrente sanguíneo asociadas a catéteres en los recién nacidos: revisión de tema. Med. Lab. [Internet]. 1 de mayo de 2015 [citado 26 de enero de 2021];21(5-6):243-54. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/122
Publicado
2015-05-01
Sección
Microbiología