2013 Volume 28 Issue 6 Pages 348-354
Hematopoietic stem cell transplantation is a standard therapy for patients with blood disease, and central venous catheter (CVC) insertion is essential for the treatment. However, Central Line-Associated Bloodstream Infection (CLABSI) may occur due to catheter insertion, and is the main cause of death after transplant surgery. To prevent CLABSI during catheter insertion, maximal sterile barrier precautions (wearing of mask, cap, sterilized gloves, and sterilized gown, and using a drape big enough to cover the patient's body) are recommended based on the known efficacy of these precautions. Many studies have investigated the correlations between care of the CVC insertion site and the incidence of CLABSI, but no study has compared the methods used at the time of dressing change. In this study, dressing change was performed at the CVC insertion site of patients who received hematopoietic stem cell transplantation by three methods; using unsterilized gloves in 14 subjects, using sterilized gloves in 11 subjects, and taking maximal sterile barrier precautions in 9 subjects, and verified which methods are effective in reducing CLABSIs. Thirteen of the 34 patients had confirmed infections. The incidence of CLABSIs per 1,000 catheter-days was 7.5 with maximal sterile barrier precautions, 9.5 with unsterilized gloves, and 10.1 with sterilized gloves. However, there was no statistically significant difference between the three methods.
