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Table 1 the characteristics of included studies

From: Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis

Author(year) Country Population Numbers of participants(Chlorhexidine / Control) Catheter Type Chlorhexidine-impregnated dressing Intervention Definition of Catheter Colonization Definition of CRBSI Conclusion
Arvaniti 2012 Greece ICU patients who required a CVC for ≥3 days 150/156 CVC after the first 24 h of catheterization, a Biopatch was placed underneath the transparent dressing, And the Biopatch was changed every 3 days, Quantitative CVC tip culture with > 1000 CFU/mL and no systemic signs of sepsis Quantitative CVC tip culture with > 1000 CFU/mL with systemic signs of sepsis Chlorhexidine-impregnated sponges and Oligon catheters as single preventive measures did not reduce catheter colonization or catheter-related infections.
Biehl 2016 Germany Patients undergoing chemotherapy with an expected duration of chemotherapy- induced neutropenia of ≥5 days and an expected CVC use of ≥10 days 307/306 Non-tunneled CVC Dressings were applied within 2 h of CVC placement and changed every 3 ± 1 days. Not availabe The results from blood and CVC tip cultures The application of chlorhexidine containing catheter securement dressings reduces the incidence of definite or probable CRBSI in neutropenic patients.
Chambers 2005 New Zealand Adult patients undergoing chemotherapy in a haematology unit. 58/54 Long-term, tunneled and cuffed CVC The Chlorhexidine impregnated dressing were applied to the exit site as soon the oozing had stopped following intravascular catheter insertion, and changed as needed or weekly. Not available Fever and positive blood cultures without alternative infection source and catheter tip culture with > 15 colonies of the same organism Chlorhexidine dressings reduced the incidence of exit-site/tunnel infections of indwelling tunnelled intravascular catheters without prolonging catheter survival in neutropenic patients
Garland 2001 USA ICU neonates with CVC expected to remain in place a minimum of 48 h 335/370 CVC and tunneled (Broviac) CVC The Chlorhexidine impregnated dressing were applied after catheterization and changed for every 7 days or as needed. Semiquantitative catheter colony count > 15 CFU Clinical infection with same organism isolated from catheter tip and blood The Chlorhexidine impregnated dressing is effective in protect against the catheter-tip colonization.
Gereker 2017 Turkey Pediatric hematologyoncology (PHO) population over 2 months of age with expected CVC duration over 48 h 14/13 CVC Care bundle with Chlorhexidine impregnated dressing being used Not availale Blood culture There was no difference between the two groups with chlorhexidine dressing or advanced dressings in terms of CRBSI
development.
Levy 2005 Israel Cardiac ICU pediatrics requiring CVC for minimum of 48 h 74/71 Short-term, nontunneled CVC The Chlorhexidine impregnated dressing were applied after catheterization and changed whenever needed. >  15 CFU by the roll-plate technique, no signs of infection Bacteremia with isolation of the same organism from CVC tip and blood The Chlorhexidine impregnated dressing is safe and significantly reduces the rates of CVC colonization in infants and children after cardiac surgery.
Pedrolo 2014 Brazil Adult ICU patients 43/42 CVC chlorhexidine antimicrobial dressing was changed every 7 days Not available Infection variables: temperature > 38 °C, systolic blood pressure < 90 mmHg, oliguria< 20 ml/h, tenderness, pain or swelling on palpation, hyperemia, cyanosis or discharge at the catheter opening; And further verified by blood culture or a culture of the catheter tip The chlorhexidine antimicrobial dressing is not effective in reducing primary bloodstream infection when compared to the gauze and tape dressing.
Roberts 1998 Australia Adult ICU patients receiving CVC over a 7-week period 17/16 CVC Chlorhexidine impregnated dressing was changed every fifth day or as needed. Same organism from CVC tip and exit site, no clinical infection Clinical infection with same organism isolated from catheter tip (and/or exit site) and blood No statistical difference was found between the two groups with regard to CVC or exit-site colonisation.
Ruschulte 2008 Germany Adults receiving chemotherapy with catheter expected for minimum of 5 d 300/301 Triple-lumen CVC The Chlorhexidine impregnated dressing were applied after catheterization Not available Clinical evidence of infection and time-to-positivity method used with CVC and peripherally drawn blood cultures The use of chlorhexidine-impregnated wound dressings significantly reduced the incidence of CVC-related infections in patients receiving chemotherapy.
Timsit 2009 France Adult ICU patients requiring catheter minimum of 48 h 817/819 CVC and/ or arterial catheter The Chlorhexidine impregnated dressing was changed 24 h after catheter insertion (day 1) and then every 3 days in the 3-day group and every 7 days in the 7-day group Quantitative CVC tip culture ≥1000 CFUs/mL Clinical infection without alternative source, peripheral blood drawn immediately prior to or within 48 h following catheter removal and quantitative catheter tip culture isolating the same organism, or confirmed using differential time to positivity test The use of Chlorhexidine impregnated dressings decreased the risk of major catheter- related infections by 60% despite a low baseline infection rate.
Timsit 2012 France ICU patients with vascular catheters inserted for an expected duration of more than 48 h 938/476 CVC The dressings were changed 24 h after catheter insertion (Day 1) then every 3 or 7 days according to standard practice in each ICU Quantitative CVC tip culture > 1000 CFU/mL and no systemic signs of sepsis Correlation between peripheral blood culture and quantitative tip culture without other likely source The Chlorhexidine-impregnated gel dressings decrease by 60% the risk of CRBSI in the ICU.
Yu 2015 China Adult internal ICU patients 189/162 CVC Chlorhexidine impregnated dressing was changed every 7 days or as needed. Not available Infection variables: blood cultures or catheter tip cultures The Chlorhexidine impregnated dressing cannot effectively reduce the incidence of CLABSI, and the cost is higher, but it can effectively reduce the number of dressing changes and save labor costs
  1. ICU intensive care unit, CVC Central venous catheter, CLABSI catheter-related bloodstream infection