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A randomised trial of 2% chlorhexidine in 70% alcohol compared with 10% povidone-iodine for venipuncture site disinfection: effects on blood culture contamination rates

Abstract number: 1732_11

Suwanpimolkul G., Pongkumpai M., Kulwichit W., Suankratay C.

Background: Contaminated blood cultures have been recognized as a bothersome issue for decades, and continue to cause a frustration for clinicians. The contamination rates vary widely between institutions from less than 1% to over 6%. Skin antiseptics can prevent the contamination of blood cultures. To our knowledge, no randomised trial of 2% chlorhexidine in 70% alcohol for venipuncture site disinfection has been conducted.

Objective: Our study was aimed to evaluate the efficacy of venipuncture site disinfection with 2% chlorhexidine in 70% alcohol compared with 10% povidone-iodine in preventing blood culture contamination.

Patients and Methods: A prospectively randomised investigator-blinded trial was conducted in all patients hospitalised in Internal Medicine wards and attended at emergency department at King Chulalongkorn Memorial Hospital, Bangkok, Thailand from August 15 to October 31, 2006. Antecubital venipuncture sites were randomly disinfected with either 2% chlorhexidine in 70% alcohol or 10% povidone-iodine, and blood cultures were drawn by medical students or residents. The blood culture contamination rate associated with each antiseptic was then determined.

Results: Of 2,146 blood culture collected during the study, 108 (5.03%) were contaminated with skin flora. The contamination rate for blood cultures after 2% chlorhexidine in 70% alcohol was 3.2% (34 of 1,068), compared with a rate of 6.9% (74 of 1,078) (P < 0.001) after 10% povidone-iodine. Of the inpatient wards, the contamination rate was 2.6% (18 of 695) and 3.9% (28 of 709) after 2% chlorhexidine in 70% alcohol and 10% povidone-iodine, respectively (P = 0.013). Of emergency department, the contamination rate was 4.3% (16 of 373) and 12.5% (46 of 369) after 2% chlorhexidine in 70% alcohol and 10% povidone-iodine, respectively (P < 0.001). The most common contaminant organism was coagulase-negative staphylococci (81%).

Conclusion: 2% chlorhexidine in 70% alcohol is superior to 10% povidone-iodine for venipuncture site disinfection before blood culture sampling.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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