The Role of Chlorhexidine Gluconate Containing Hydrogel Pad Dressings in Preventing Catheter- Related Bloodstream Infections in the Intensive Care Unit: A Prospective Single-Center Observational Study

Abstract

The Role of Chlorhexidine Gluconate Containing Hydrogel Pad Dressings in Preventing Catheter- Related Bloodstream Infections in the Intensive Care Unit: A Prospective Single-Center Observational Study

Abstract

Background and Purpose: Catheter-related bloodstream infections (CRBSIs) remain a significant cause of morbidity and mortality in intensive care units (ICUs). Chlorhexidine gluconate (CHG)-impregnated dressings may reduce catheter colonization and infection. This prospective single-center observational study evaluated the effectiveness and safety of a 2% CHG-containing hydrogel pad dressing in preventing local infection and CRBSI in critically ill adults. Methods:
Between June and December 2025, adult ICU patients who underwent jugular or subclavian central venous catheter insertion and received a 2% CHG hydrogel pad dressing were included. Patients were followed daily for seven days and assessed for dermatitis, local infection, and CRBSI. Results:
A total of 122 patients (mean age 68.4±16 years; 52.5% male) were included. Only one patient (0.8%) developed a local infection; no CRBSI was observed. The catheter-related infection incidence density was 1.34/1000 catheter-days (95% CI: 0.03–7.48). No dermatitis or allergic reactions occurred. Dressing detachment was noted in 4.1% of cases. Conclusion:
The 2% CHG hydrogel pad dressing was associated with low infection rates. Controlled comparative studies are warranted.

Keywords

• Catheter-Related Infections
• Chlorhexidine
• Intensive Care Units
• Dermatitis

References

1. Wei L, Li Y, Li X, Bian L, Wen Z, Li M. Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis. BMC Infect Dis. 2019;19(1):429.
2. Haddadin Y, Annamaraju P, Regunath H. Central Line–Associated Blood Stream Infections. [Updated 2022 Nov 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430891/
3. Tacconelli E, Smith G, Hieke K, Lafuma A, Bastide P. Epidemiology, medical outcomes and costs of catheter-related bloodstream infections in intensive care units of four European countries: literature- and registry-based estimates. J Hosp Infect. 2009;72(2):97-103.
4. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Bulaşıcı Hastalıklar ve Erken Uyarı Dairesi Başkanlığı. Ulusal Sağlık Hizmeti ile İlişkili Enfeksiyonlar Sürveyans Ağı (USHİESA) Özet Raporu 2024 [Internet]. [updated 08 Jan 2026; Accessed date: 17.02.26. Available from: https://hsgm.saglik.gov.tr/media/attachments/2025/06/23/ek_ulusal-saglik-hizmeti-ile-Iliskili-enfeksiyonlar-surveyans-agi-ushIesa-Ozet-raporu-2024.pdf
5. Renaud B, Brun-Buisson C. Outcomes of primary and catheter-related bacteremia. A cohort and case-control study in critically ill patients. Am J Respir Crit Care Med. 2001;163(7):1584-90.
6. Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039-46.
7. Mosquera JMA, Assis Reveiz JK, Barrera L, Liscano Y. Impact of central line-associated bloodstream infections on mortality and hospital stay in adult patients at a tertiary care institution in Cali, Colombia, 2015-2018. J Clin Med. 2024;13(18):5376.
8. Olaechea PM, Palomar M, Álvarez-Lerma F, Otal JJ, Insausti J, López-Pueyo MJ. Morbidity and mortality associated with primary and catheter-related bloodstream infections in critically ill patients. Rev Esp Quimioter. 2013;26(1):21-9.

9. Safdar N, O'Horo JC, Ghufran A, et al. Chlorhexidine-impregnated dressing for prevention of catheter-related bloodstream infection: a meta-analysis. Crit Care Med. 2014;42(7):1703-13.
10. Daniels KR, Frei CR. Antimicrobial-impregnated discs for prevention of intravenous catheter-related infections. Am J Infect Dis. 2012;8(1):50-59.
11. Timsit JF, Mimoz O, Mourvillier B, et al. Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med. 2012;186(12):1272-8.
12. Wang HX, Xie SY, Wang H, Chu HK. The effects of chlorhexidine dressing on health care-associated infection in hospitalized patients: a meta-analysis. Iran J Public Health. 2019;48(5):796-807.
13. O'Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93.
14. Masferrer E, Riera-Rodríguez L, Farré-Alins V, et al. Randomized controlled trial on healthy volunteers of pharmacokinetic and antimicrobial activity of a novel hydrogel-containing chlorhexidine dressing to prevent catheter-related bloodstream infection. Front Med. 2024;10:1335364.
15. Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355(26):2725-32.
16. Biehl LM, Huth A, Panse J, et al. A randomized trial on chlorhexidine dressings for the prevention of catheter-related bloodstream infections in neutropenic patients. Ann Oncol. 2016;27(10):1916-22.
17. Jenks M, Craig J, Green W, et al. Tegaderm CHG IV Securement Dressing for Central Venous and Arterial Catheter Insertion Sites: a NICE medical technology guidance. Appl Health Econ Health Policy. 2016;14(2):135-49.
18. Thokala P, Arrowsmith M, Poku E, et al. Economic impact of Tegaderm chlorhexidine gluconate (CHG) dressing in critically ill patients. J Infect Prev. 2016;17(5):216-23.
19. Ullman AJ, Cooke ML, Mitchell M, et al. Dressings and securement devices for central venous catheters (CVC). Cochrane Database Syst Rev. 2015;2015(9):CD010367.
20. Bion J, Richardson A, Hibbert P, et al. ‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England. BMJ Qual Saf. 2013;22(2):110-23.
21. Garland JS, Alex CP, Mueller CD, 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(6):1431-6.
22. Timsit JF, Schwebel C, Bouadma L, et al. Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA. 2009;301(12).