Table 1.
Characteristics of the study population (ICUs), outcomes and crude incidence rate ratios of intervention versus baseline periods, according to the study group
| Parameter | Description | Study group | |||||
|---|---|---|---|---|---|---|---|
| Chlorhexidine | Octenidine | Routine care (control arm) | |||||
| Baseline | Intervention | Baseline | Intervention | Baseline | Intervention | ||
| ICUs | N | 24 | 24 | 24 | 24 | 24 | 24 |
| Patients | N | 21,346 | 22,897 | 26,095 | 25,127 | 28,698 | 28,791 |
| Patient days | N | 75,593 | 85,135 | 92,597 | 90,820 | 98,726 | 103,356 |
| CL days | N | 46,011 | 54,305 | 60,430 | 58,656 | 66,670 | 70,068 |
| Length of stay (days)b | Pooled mean | 3.5 | 3.6 | 3.7 | 3.4 | 3.5 | 3.6 |
| Median (IQR), P valuea | 3.7 (2.6–4.6) | 3.6 (2.7–4.2), 0.9179a | 3.6 (2.7–4.5) | 3.6 (2.7–4.5), 1.000a | 3.3 (2.9–4.2) | 3.3 (2.9–4.6), 0.7880a | |
| CL use (%)b | Pooled mean | 60.9 | 64.6 | 63.8 | 67.53 | 65.3 | 67.8 |
| Median (IQR), P valuea | 63.4 (55.6–77.5) | 67.9 (55.8–77.6), 0.8366a | 68.4 (45.3–78.5) | 64.9 (43.7–77.5), 0.8528a | 68.5 (60.0–76.8) | 65.3 (58.6–79.1), 0.8200a | |
| Mechanical ventilation (%)b | Pooled mean | 34.4 | 30.8 | 37.7 | 35.5 | 31.9 | 36.9 |
| Median (IQR), P valuea | 33.2 (24.6–45.9) | 33.1 (26.7–47.4), 0.8206a | 28.2 (17.9–41.3) | 30.1 (16.6–39.5), 0.9671a | 32.2 (24.4–44.9) | 34.5 (24.6–48.1), 0.8850a | |
| Outcomes | |||||||
| CLABSI with any pathogen | N | 68 | 49 | 76 | 86 | 80 | 82 |
| ID/1000 CL days (95% CI) | 1.48 (1.15–1.87) | 0.90 (0.67–1.19) | 1.26 (0.99–1.57) | 1.47 (1.17–1.81) | 1.20 (0.95–1.49) | 1.17 (0.93–1.45) | |
| Compared to baseline in each study group | IRR (95% CI), P value | 1 = reference | 0.61 (0.42–0.88), 0.0085 | 1 = reference | 1.17 (0.86–1.59), 0.3298 | 1 = reference | 0.98 (0.72–1.33), 0.8735 |
| CLABSI with gram-positive bacteria | N | 45 | 28 | 51 | 72 | 52 | 55 |
| ID/1000 CL days (95% CI) | 0.98 (0.71–1.31) | 0.52 (0.34–0.75) | 0.84 (0.63–1.11) | 1.23 (0.96–1.55) | 0.78 (0.58–1.02) | 0.79 (0.59–1.02) | |
| Compared to baseline in each study group | IRR (95% CI), P value | 1 = reference | 0.53 (0.33–0.85), 0.0078* | 1 = reference | 1.45 (1.02–2.08), 0.0407* | 1 = reference | 1.01 (0.69–1.47), 0.9737 |
| CLABSI with CoNS | N | 25 | 11 | 31 | 43 | 25 | 26 |
| ID/1000 CL days (95% CI) | 0.54 (0.35–0.80) | 0.20 (0.10–0.36) | 0.51 (0.35–0.73) | 0.73 (0.53–0.98) | 0.38 (0.24–0.55) | 0.37 (0.24–0.564) | |
| Compared to baseline in each study group | IRR (95% CI), P value | 1 = reference | 0.37 (0.18–0.76), 0.0064* | 1 = reference | 1.43 (0.90–2.27), 0.1297 | 1 = reference | 0.99 (0.57–1.71), 0.9701 |
| CLABSI with gram-negative bacteria | N | 11 | 12 | 16 | 12 | 14 | 22 |
| ID/1000 CL days (95% CI) | 0.24 (0.12–0.43) | 0.22 (0.11–0.39) | 0.27 (0.15–0.43) | 0.21 (0.11–0.36) | 0.21 (0.12–0.35) | 0.31 (0.20–0.48) | |
| Compared to baseline in each study group | IRR (95% CI), P value | 1 = reference | 0.92 (0.41–2.10), 0.8504 | 1 = reference | 0.77 (0.37–1.63), 0.4995 | 1 = reference | 1.50 (0.77–2.92), 0.2393 |
Baseline period included 12 months before the intervention was started. Parts of the intervention period have been shown elsewhere [15]. CLABSI, central line associated bloodstream infection. CL, central line. 95% CI, 95% confidence interval. ID, incidence densities per 1000 CL days. IRR, incidence rate ratios calculated by Poisson regression comparing intervention period to baseline period in each study group. CoNS, coagulase-negative staphylococci. aP values based on comparison of intervention period to baseline period in each study group. bP values were not shown because there were no differences between the three groups during the intervention period. *P values < 0.05 were considered significant