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A Randomized Study Comparing a Transparent Polyurethane Dressing to a Dry Gauze Dressing for Peripheral Intravenous Catheter Sites

Published online by Cambridge University Press:  02 January 2015

Donald E. Craven*
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
Deborah A. Lichtenberg
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
Laureen M. Kunches
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
Ann T. McDonough
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
Maria I. Gonzalez
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
Timothy C. Heeren
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
William R. McCabe
Affiliation:
Division of Infectious Diseases, Departments of Medicine, Epidemiology and Nursing, Boston University School of Medicine, Boston City Hospital, Boston, Massachusetts
*
Hospital Epidemiology Section, Maxwell Finland Laboratory for Infectious Diseases, Boston City Hospital, Boston, MA 02118

Abstract

We studied rates of peripheral intravenous (IV) catheter tip and insertion site colonization after randomly assigning patients to transparent polyurethane (TP) dressings (N=316) or dry gauze (DG) dressings (N=421). The study was conducted during both summer and fall seasons, in a facility which lacked air conditioning. All patients had a teflon plastic catheter inserted, maintained and cultured by a member of the IV therapy team; no antibiotic or antiseptic ointments were used. Colonization rates were higher in the summer than in the fall for both catheter tips (9.0% vs 3.5%, p=0.005) and sites (21.6% vs 7.0%, p=0.001). During the summer season, the rate of catheter tip colonization with TP dressings was nearly twice that of DG dressings (12.4% vs 6.8%, p=0.04). Logistic regression analysis indicated that catheter tip colonization was associated with the summer season (odds ratio=3.0, 95% CI 1.4-6.2) and TP dressings (odds ratio=1.8, 95% CI 1.1-3.2), and that site colonization was associated with both summer (odds ratio=4.0, 95% CI 2.2-7.1) and receipt of antibiotics (odds ratio=1.9, 95% CI 1.1-3.2). Coagulase-negative staphylococci were isolated from 55.5% of the colonized catheter tips and insertion sites. The data suggest that bacterial colonization of peripheral IV catheters is increased in summer, and that use of TP dressings may increase both tip colonization and cost nearly twofold.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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