Chlorhexidine Gluconate for Skin Preparation During Catheter Insertion and Surgical Procedures [Internet]

Excerpt

Health care–associated infections (HAIs), many of which are preventable, represent a large proportion of adverse events experienced by those receiving care in the Canadian health care system. It is estimated that the prevalence of patients in Canada with at least 1 HAI was 7.9% in 2017 and that device-associated infections accounted for 35.6% of all HAIs. It is also estimated that 9% of HAIs observed in Canadian hospitals were caused by an antimicrobial-resistant organism such as, for example, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The management of HAIs in Canada incurs substantial costs to the health care system, contributes to lengthier hospital stays, and places an added burden on an already strained system. For example, the Canadian Institute for Health Information estimated that HAIs were associated with a cost of $281 million dollars in 2014–2015. Infection prevention measures, such as skin cleaning before a procedure or at regular intervals for venous access sites, have been implemented as a strategy to reduce the prevalence HAIs.

Chlorhexidine gluconate (CHG) is an antiseptic that can be used for skin cleaning and has been shown to be effective against a wide range of organisms, including some antimicrobial-resistant organisms. CHG is manufactured in several different formulations and concentrations, such as hand scrubs, concentrated solutions that can be diluted with water or alcohol, and CHG-impregnated wipes or sponges. While disposable CHG wipes may be convenient, offer good contact with the skin, and uniformity in skin coverage, there are remaining questions regarding their clinical effectiveness compared to other CHG products and skin cleaning techniques.

The objective of this report is to summarize the evidence regarding the clinical effectiveness of CHG wipes for infection prevention in patients being prepped for urinary catheter insertion and in patients who are preoperative and/or in critical care settings.