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J Med Assoc Thai ; 97 Suppl 8: S34-40, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25518291

RESUMEN

BACKGROUND: Blood culture is the gold standard for diagnosis of septicemia. However; false-positive blood cultures are associated with increased health care costs due to unnecessary treatment. OBJECTIVE: To evaluate the efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in reducing blood culture contamination inpediatricpatients. MATERIAL AND METHOD: This is a prospective study of pediatric patients who were admitted at a tertiary-care hospital. Pediatric patients who neededpercutaneous blood cultures were recruitedfrom two general pediatric wards and the pediatric intensive care unit. The authors used 10% povidone iodine as an antiseptic in odd months and 2% chlorhexidine gluconate in 70% alcohol as an antiseptic in even months in obtaining the blood culture samples. RESULTS: There were 1,269 blood culture specimens taken from 821 patients. 654 specimens used 10%povidone iodine as an antiseptic and 619 specimens used 2% chlorhexidine gluconate in 70% alcohol as an antiseptic. The 10% povidone iodine group and the 2% chlorhexidine gluconate in 70% alcohol group had the risk of blood culture contamination of 3.21% (95%CI: 2.00%-4.87%) and 2.28% (95% CI: 1.25%-3.79%) respectively. The risk difference ofblood culture contamination was 0.93% (95% confidence interval: 0. 86-2.72%) with p = 0.31. The most common contamination organism was Coagulase negative staphylococci (68.57%). No adverse skin reactions were observed in both antiseptic solutions groups. CONCLUSION: Use of2% chlorhexidine gluconate in 70% alcohol as an antiseptic seems to reduce the risk of blood culture contamination compared to use of 10% povidone iodine. In addition, neither of the antiseptic solutions resulted in adverse skin reactions.


Asunto(s)
Antiinfecciosos Locales/uso terapéutico , Antisepsia/métodos , Recolección de Muestras de Sangre/métodos , Clorhexidina/análogos & derivados , Etanol/uso terapéutico , Povidona Yodada/uso terapéutico , Sepsis/diagnóstico , Piel/microbiología , Adolescente , Niño , Preescolar , Clorhexidina/uso terapéutico , Técnicas de Cultivo , Reacciones Falso Positivas , Femenino , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Estudios Prospectivos
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