The Efficacy of 2% Chlorhexidine Gluconate in 70% Alcohol Compared with 10% Povidone Iodine in Reducing Blood Culture Contamination in Pediatric Patients
Auchara Tangsathapornpong MD*, Pornumpa Banjongmanee MD*, Kengkaj Unrit MD*, Paskorn Sritipsukho MD*, Narisara Mungkornkaew MT**, Sirinporn Sajak RN***
Affiliation : * Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Microbiology Laboratory, Thammasat University Hospital, Pathumthani, Thailand *** Infection Control Unit, Thammasat University Hospital, Pathumthani, Thailand
Background : Blood culture is the gold standard for diagnosis of septicemia. However, false-positive blood cultures are
associated with increased health care costs due to unnecessary treatment.
Objective : To evaluate the efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in
reducing blood culture contamination in pediatric patients.
Material and Method: This is a prospective study of pediatric patients who were admitted at a tertiary-care hospital.
Pediatric patients who needed percutaneous blood cultures were recruited from two general pediatric wards and the pediatric
intensive care unit. The authors used 10% povidone iodine as an antiseptic in odd months and 2% chlorhexidine gluconate
in 70% alcohol as an antiseptic in even months in obtaining the blood culture samples.
Results : There were 1,269 blood culture specimens taken from 821 patients. 654 specimens used 10% povidone iodine as an
antiseptic and 619 specimens used 2% chlorhexidine gluconate in 70% alcohol as an antiseptic. The 10% povidone iodine
group and the 2% chlorhexidine gluconate in 70% alcohol group had the risk of blood culture contamination of 3.21%
(95%CI: 2.00%-4.87%) and 2.28% (95% CI: 1.25%-3.79%) respectively. The risk difference of blood culture contamination
was 0.93% (95% confidence interval: 0.86-2.72%) with p = 0.31. The most common contamination organism was Coagulase
negative staphylococci (68.57%). No adverse skin reactions were observed in both antiseptic solutions groups.
Conclusion : Use of 2% chlorhexidine gluconate in 70% alcohol as an antiseptic seems to reduce the risk of blood culture
contamination compared to use of 10% povidone iodine. In addition, neither of the antiseptic solutions resulted in adverse
skin reactions.
Keywords : Blood culture, Contamination, Chlorhexidine gluconate, Povidone iodine
