Comparison of alcohol, povidone-iodine and octenidine dihydrochloride as skin disinfectants to reduce bacterial count prior to peripheral venous catheter insertions in newborn infants

  • Lily Rundjan Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Rinawati Rohsiswatmo Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Sarah Rafika Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Enty Enty Department of Microbiology, Catholic University of Atmajaya Medical School, Jakarta
  • Lucky H. Moehario Department Microbiology, University of Indonesia Medical School, Jakarta
DOI: https://doi.org/10.14238/pi51.5.2011.277-81
Keywords: octenidine, 70% alcohol, 10% povidone-iodine, reduction bacterial count, newborns

Abstract

Abstract
Background Vascular access may increase the risk of bloodstream infections, especially in newborn infants with weak immune systems and requiring invasive supportive care. Skin disinfection prior to peripheral venous catheter insertion lowers the risk of infection. However, antiseptics chosen for this task should be effective and safe for newborn infants.
Objective To compare the effectiveness of 70% alcohol (BD alcohol swabs ®), 10% povidone-iodine (Pharma-RSUPNCM), and octenidine (Octenisept ®) as antiseptics for reducing skin bacteria for pre-invasive procedures in neonates.
Methods Infants aged less than 28 days, regardless of gestational age, at the Neonatal Unit of Cipto Mangunkusumo Hospital (RSUPNCM) were included in our study. Infants were divided into three groups, each tested with different skin antiseptics (alcohol, povidone-iodine or octenidine). Skin swabs were performed before and after application of skin antiseptic, followed by inoculation onto blood agar plates. Colony-forming units were counted after 18 hours of incubation at 37ºC.
Results Ninety subjects were divided into 3 groups of 30, each group using either 70% alcohol swabs, 10% povidone-iodine, or octenidine as skin antiseptic. Skin swabs were taken before and after antiseptic application and drying, as well as 5 minutes after application. The mean reductions in CFU/cm2 (%) after antiseptic application (and fully dried) were 97.54% for povidone-iodine, 97.52% for octenidine, and 89.07% for alcohol. There were no significant differences in mean CFU reductions among the three antiseptics groups (P=0.299). Furthermore, 5 minutes after application, there were still no significant differences in the three antiseptic groups (P=0.289).

Conclusions Although octenidine showed a significant bacterial count reduction after application, it was not significantly different from those of alcohol or povidone-iodine. [Paediatr Indones. 2011;51:277-81].

References

1. Siegel JD. The newborn nursery and the neonatal intensive care unit. In: Jarvis WR, editor. Bennett and Brachman’s hospital infections. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 417-47.
2. Cooley K, Grady S. Minimizing catheter-related bloodstream infections: one unit’s approach. Adv Neonatal Care. 2009;9:209-26.
3. Centers for Disease Control and Prevention. Guidelines for the prevention of intravascular catheter-related infections; 2011 [cited 2011 March 15. Available from: http://www.cdc.gov/hicpac/bsi/bsi-guidelines-2011.html
4. Irving V. Skin problems in the pre-term infant: avoiding ritualistic practice. Prof Nurse. 2001;17:63-6.
5. Mullany LC, Darmstadt GL, Tielsch JM. Safety and impact of chlorhexidine antisepsis interventions for improving neonatal health in developing countries. Pediatr Infect Dis J. 2006;25:665-75.
6. Malathi I, Millar MR, Leeming JP, Hedges A, Marlow N. Skin disinfection in preterm infants. Arch Dis Child. 1993;69:312-6.
7. Bührer C, Bahr S, Siebert J, Wettstein R, Geffers C, Obladen M. Use of 2% 2-phenoxyethanol and 0.1% octenidine as antiseptic in premature newborn infants of 23-26 weeks gestation. J Hosp Infect. 2002;51:305-7.
8. Dettenkofer M, Jonas D, Wiechmann C, Rossner R, Frank U, Zentner J, et al. Effect of skin disinfection with octenidine dihydrochloride on insertion site colonization of intravascular catheters. Infection. 2002;30:282-5.
9. Koburger T, Hübner NO, Braun M, Siebert J, Kramer A. Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate. J Antimicrob Chemother. 2010;65:1712-9.
10. Darmstadt GL, Hossain MM, Choi Y, Shirin M, Mullany LC, Islam M, et al. Safety and effect of chlorhexidine skin cleansing. Pediatr Infect Dis J. 2007;26:492-5.
Published
2011-10-31
How to Cite
1.
Rundjan L, Rohsiswatmo R, Rafika S, Enty E, Moehario L. Comparison of alcohol, povidone-iodine and octenidine dihydrochloride as skin disinfectants to reduce bacterial count prior to peripheral venous catheter insertions in newborn infants. PI [Internet]. 31Oct.2011 [cited 24Nov.2024];51(5):277-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/710
Issue
Vol 51 No 5 (2011): September 2011
Section
Articles

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Received 2016-09-27
Accepted 2016-09-27
Published 2011-10-31