Povidone-iodine lowers the incidence of catheter-associated bloodstream infection

Pediatr Int. 2019 Mar;61(3):230-234. doi: 10.1111/ped.13759. Epub 2019 Mar 18.

Abstract

Background: Central venous (CV) catheters are required for chemotherapy but they may become a source of life-threatening infections of the bloodstream. The most effective way to disinfect the port of a CV catheter has not been established.

Methods: We report the data obtained between April 2008 and March 2010 using 83% ethanol (period I) and between April 2010 and March 2014 using 10% povidone-iodine (period II) to sterilize the access port. The participants received chemotherapy or autologous/allogeneic stem cell transplantation at the present institution.

Results: No significant difference was observed in patient characteristics between the two periods, such as disease, median age, or the period of neutropenia. The incidence of positive blood culture during periods I and II was 18.5% (31/168) and 11.4% (40/350; P = 0.041), respectively. The incidence of catheter-associated bloodstream infection on blood culture during periods I and II was 11.9% (20/168) and 6.3% (22/350; P = 0.043), respectively. Bacillus cereus infection was not detected during period II.

Conclusion: The incidence of infection caused by CV catheters was significantly reduced using povidone-iodine; therefore, we recommend this procedure as part of the routine in chemotherapy.

Keywords: catheter-related infection; central venous catheter; neoplasm; neutropenia; povidone-iodine.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anti-Infective Agents, Local / administration & dosage*
  • Bacteremia / epidemiology*
  • Bacteremia / etiology
  • Bacteremia / prevention & control
  • Blood Culture / methods
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control*
  • Catheterization, Central Venous / adverse effects*
  • Child
  • Child, Preschool
  • Ethanol / administration & dosage
  • Febrile Neutropenia
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Povidone-Iodine / administration & dosage*
  • Retrospective Studies
  • Sterilization / methods
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Ethanol
  • Povidone-Iodine