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Effectiveness of chlorhexidine gluconate-impregnated dressings in preventing central line-associated bloodstream infection in a paediatric intensive care unit: A randomised controlled trial.

Francisco Javier Portero-Prados·Manuel Pabón-Carrasco·José Antonio Ponce-Blandón
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Abstract

OBJECTIVES: To compare the effectiveness and dermatological safety of chlorhexidine gluconate (CHG)-impregnated dressings versus conventional transparent dressings in preventing central line-associated bloodstream infection (CLABSI) in paediatric patients admitted to a PICU. METHODS: A single-blind, randomised controlled trial with a 1:1 allocation ratio was conducted in a tertiary PICU. A total of 250 paediatric patients with a central venous catheter were included (125 per group). Patient characteristics, catheter-related variables, catheter dwell time and skin alterations were recorded. The primary outcome was CLABSI, defined according to CDC/NHSN criteria. Bivariate analyses and multivariable logistic regression were performed, including clinically relevant covariates related to catheter exposure, dressing type, and vaccination status. The trial was registered at ClinicalTrials.gov (NCT07175116). RESULTS: CLABSI incidence was significantly lower in the CHG group compared with the conventional dressing group (2.4% vs. 18.4%; p&#xa0;<&#xa0;0.001). In multivariable analysis, CHG-impregnated dressings were independently associated with reduced CLABSI risk (OR = 0.15; 95% CI: 0.04-0.58). Longer catheter dwell time (OR = 1.13 per day; 95% CI: 1.04-1.22) and absence of complete vaccination (OR = 8.68; 95% CI: 2.48-30.47) were also associated with increased infection risk. Incomplete vaccination showed a similar trend without reaching statistical significance (OR = 6.48; 95% CI: 0.95-44.20). Skin alterations were more frequent in the CHG group (16.8% vs. 11.2%), predominantly in younger infants. CONCLUSIONS: CHG-impregnated dressings were associated with a significant reduction in CLABSI incidence in critically ill paediatric patients, although their use was linked to a modest increase in mild skin reactions. IMPLICATIONS FOR CLINICAL PRACTICE: CHG-impregnated dressings may be considered as part of a multifaceted infection prevention strategy, alongside appropriate catheter management, minimisation of catheter manipulation and proactive skin monitoring, with cautious and individualised use in infants.

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HumansChlorhexidineFemaleMaleCatheter-Related InfectionsBandagesIntensive Care Units, PediatricInfantChild, PreschoolSingle-Blind MethodChildAnti-Infective Agents, LocalCatheterization, Central VenousCatheter dressingCentral line&#x2013;associated bloodstream infectionCentral venous catheterChlorhexidine gluconateInfection preventionNursing carePaediatric intensive carePatient safetyJournal ArticleRandomized Controlled Trial

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Francisco Javier Portero-Prados, Manuel Pab&#xf3;n-Carrasco, Jos&#xe9; Antonio Ponce-Bland&#xf3;n. 2026-05-07. Effectiveness of chlorhexidine gluconate-impregnated dressings in preventing central line-associated bloodstream infection in a paediatric intensive care unit: A randomised controlled trial.. https://doi.org/10.1016/j.iccn.2026.104441

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Journal Article; Randomized Controlled Trial resourceAnti-Infective Agents, Local subjectChild subjectChild, Preschool subjectFemale subjectHumans subjectInfant subjectJournal Article subjectMale subjectPatient Safety subjectRandomized controlled trials study

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