Prospective Randomized Controlled Multicenter Trial of 4 Antiseptic Strategies for Prevention of Catheter Infection in Intensive Care Unit for Adults Patients

Catheter related infection is the third cause of nosocomial infection in ICUs. Most of them are avoidable and can be prevent by improving aseptic practices during catheter insertion and maintenance. Indeed, the main route of catheter contamination for short-term catheters is the insertion site. Consequently, the quality of skin disinfection is the most effective preventive measure to reduce the incidence of these infections.

This aim of the present study is to compare four strategies of skin disinfection to determine whether a 2% alcoholic solution of chlorhexidine acts better than 5% alcoholic povidone iodine in reducing catheter infection and to assess whether a detersion phase prior to disinfection reduces catheter colonization as compared with no detersion.

Inclusion Criteria:

• ≥ 18 year-old
• Expected duration of ICU stay ≥ 48 hours
• Patient requiring the insertion of at least one arterial catheter and/or central venous catheter and/or catheter for hemodialysis.

Exclusion Criteria:

• Patient with history of allergy to any of the antiseptic agent studied
• Expected survival < 48 hours
• Catheter inserted outside the ICU or in emergency without respect of preventive measures.
• Use of antimicrobial impregnated catheters or antiseptic impregnated dressings.
• Pregnant woman or breast-feeding mother