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Skin Antisepsis Kits Containing Alcohol and Chlorhexidine Gluconate or Tincture of Iodine are Associated With Low Rates of Blood Culture Contamination

Published online by Cambridge University Press:  02 January 2015

Barbara W. Trautner
Affiliation:
Department of Medicine, Infectious Diseases Section, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
Jill E. Clarridge
Affiliation:
Department of Pathology, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
Rabih O. Darouiche*
Affiliation:
Department of Medicine, Infectious Diseases Section, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas Department of Physical Medicine and Rehabilitation, Center for Prosthesis Infection, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
*
Center for Prosthesis Infection, Baylor College of Medicine, 1333 Moursund Avenue, Suite A221, Houston, TX 77030

Abstract

Objective:

Skin preparation is an important factor in reducing the rate of blood culture contamination. We assessed blood culture contamination rates associated with the use of skin antisepsis kits containing either 2% alcoholic chlorhexidine gluconate or 2% alcoholic tincture of iodine.

Design:

Prospective, blinded clinical trial.

Setting:

Tertiary-care teaching hospital.

Patients:

Adult patients in medical wards, the medical intensive care unit, and the cardiac intensive care unit who needed paired, percutaneous blood cultures.

Interventions:

House officers, medical students, and healthcare technicians drew the blood for cultures. We prepared sacks containing all of the necessary supplies, including two different types of antiseptic kits. In each sack, one kit contained 2% chlorhexidine in 70% isopropyl alcohol and the other contained 2% tincture of iodine in ethyl alcohol and 70% isopropyl alcohol. Each patient received chlorhexidine at one site and tincture of iodine at the other.

Results:

Four (0.9%) of 430 blood culture sets from 215 patients were contaminated. The contamination rate when using alcohol and chlorhexidine (1 of 215, 0.5%) did not differ significantly from the contamination rate when using tincture of iodine (3 of 215,1.4%; P = .62, McNemar test). There was an 87% probability that the two interventions differed by less than 2% in their rate of contamination.

Conclusions:

Both of these antiseptic kits were highly effective for skin preparation prior to drawing blood for cultures. The use of these kits may have contributed to the low contamination rate observed in this study.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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