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Effect of chlorhexidine and urinary catheter infection prevention in a Brazilian coronary ICU

Introduction

Urinary catheter insertion is a common procedure in ICUs and can be an important cause of infection in the hospital environment [1, 2]. We aimed to analyze the effect of chlorhexidine on long-term urinary catheter insertion and urinary tract infection (UTI) during a 5-year period in patients admitted to a coronary ICU.

Methods

Analysis of patients admitted to a coronary ICU of a medium-sized hospital in Brazil from January 2010 to May 2014. The institutional protocol of periprocedural antisepsis was changed from iodine-based antiseptic to chlorhexidine in 2012. The UTI diagnosis was based on urine culture (>105 colony-forming units per ml of urine) associated with at least one clinical/laboratory abnormality (fever >38°C, urination urgency, increased urinary frequency, dysuria, or suprapubic or lumbar pain). The UTI rate represents the urinary tract infections associated with long-term urinary catheter (patient with UTI associated with long-term urinary catheter divided by patients with long-term urinary catheter × 1,000).

Results

The urinary tract infection rates were 4.8 (year 2010: patients·day-1 (n: 2,511), long-term urinary catheter·day-1 (n: 1,455), device usage rate 958%)), 4.4 (year 2011: patients·day-1 (n: 2,529), long-term urinary catheter·day-1 (n: 1,140), device usage rate (45%)), 0.0 (year 2012: patients·day-1 (n: 2,660), long-term urinary catheter·day-1 (n: 783), device usage rate (29%)), 0.0 (year 2013: patients·day-1 (n: 2,573), long-term urinary catheter·day-1 (n: 960), device usage rate (37%)), and 0.0 (year 2014: patients·day-1 (n: 1,070), long-term urinary catheter·day-1 (n: 444), device usage rate (42%)).

Conclusion

The use of chlorhexidine in the periprocedural antisepsis of urinary catheterization contributed to the decrease of urinary tract infections associated with long-term urinary catheter in patients admitted to the coronary ICU.

References

  1. 1.

    Silva E, et al: Crit Care. 2004, 8: R251-60. 10.1186/cc2892.

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  2. 2.

    Vincent JL, et al: JAMA. 2009, 302: 2323-9. 10.1001/jama.2009.1754.

    CAS  Article  PubMed  Google Scholar 

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Correspondence to GM Plantier.

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Plantier, G., Bosso, C., Azevedo, B. et al. Effect of chlorhexidine and urinary catheter infection prevention in a Brazilian coronary ICU. Crit Care 19, P80 (2015). https://doi.org/10.1186/cc14160

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Keywords

  • Catheter
  • Urinary Tract Infection
  • Urine Culture
  • Chlorhexidine
  • Infection Prevention