- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT01629550
Prospective Randomized Controlled Multicenter Trial of 4 Antiseptic Strategies for Prevention of Catheter Infection in Intensive Care Unit for Adults Patients (CLEAN)
Catheter related infection is the third cause of nosocomial infection in ICUs. Most of them are avoidable and can be prevent by improving aseptic practices during catheter insertion and maintenance. Indeed, the main route of catheter contamination for short-term catheters is the insertion site. Consequently, the quality of skin disinfection is the most effective preventive measure to reduce the incidence of these infections.
This aim of the present study is to compare four strategies of skin disinfection to determine whether a 2% alcoholic solution of chlorhexidine acts better than 5% alcoholic povidone iodine in reducing catheter infection and to assess whether a detersion phase prior to disinfection reduces catheter colonization as compared with no detersion.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription
Phase
- Phase 4
Contacts et emplacements
Lieux d'étude
-
-
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Angers, France, 49933
- Angers University Hospital
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Clermont-Ferrand, France, 63000
- Estain University Hospital
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Paris, France, 75018
- Bichat-Claude Bernard Hospital
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Pierre Benite, France, 69465
- Lyon University Hospital
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Poitiers, France, 86021
- Poitiers University Hospital
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- ≥ 18 year-old
- Expected duration of ICU stay ≥ 48 hours
- Patient requiring the insertion of at least one arterial catheter and/or central venous catheter and/or catheter for hemodialysis.
Exclusion Criteria:
- Patient with history of allergy to any of the antiseptic agent studied
- Expected survival < 48 hours
- Catheter inserted outside the ICU or in emergency without respect of preventive measures.
- Use of antimicrobial impregnated catheters or antiseptic impregnated dressings.
- Pregnant woman or breast-feeding mother
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Comparateur actif: PVI paint
5% alcoholic povidone iodine paint
|
|
Comparateur actif: PVI scrub and paint
detersion with 4% povidone iodine scrub followed by 5% alcoholic povidone iodine paint
|
|
Comparateur actif: Chlorhexidine paint
2% alcoholic chlorhexidine paint
|
|
Comparateur actif: chlorhexidine scrub and paint
Detersion with 4% chlorhexidine scrub followed 2% alcoholic chlorhexidine paint
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
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Major catheter related infection
|
Mesures de résultats secondaires
Mesure des résultats |
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Frais
|
Colonisation du cathéter
|
Catheter related bacteremia
|
Colonization insertion site
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Prolongation hospitalization due to catheter infection
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Mortality due to catheter infection
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Skin allergy and anaphylactic shock
|
Collaborateurs et enquêteurs
Parrainer
Publications et liens utiles
Publications générales
- Iachkine J, Buetti N, de Grooth HJ, Briant AR, Mimoz O, Megarbane B, Mira JP, Ruckly S, Souweine B, du Cheyron D, Mermel LA, Timsit JF, Parienti JJ. Development and validation of a multivariable prediction model of central venous catheter-tip colonization in a cohort of five randomized trials. Crit Care. 2022 Jul 7;26(1):205. doi: 10.1186/s13054-022-04078-x.
- Buetti N, Ruckly S, Lucet JC, Bouadma L, Schwebel C, Mimoz O, Timsit JF. Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials. Ann Intensive Care. 2020 Jul 8;10(1):89. doi: 10.1186/s13613-020-00705-4.
- Maunoury F, Farinetto C, Ruckly S, Guenezan J, Lucet JC, Lepape A, Pascal J, Souweine B, Mimoz O, Timsit JF. Cost-effectiveness analysis of chlorhexidine-alcohol versus povidone iodine-alcohol solution in the prevention of intravascular-catheter-related bloodstream infections in France. PLoS One. 2018 May 25;13(5):e0197747. doi: 10.1371/journal.pone.0197747. eCollection 2018.
- Mimoz O, Lucet JC, Kerforne T, Pascal J, Souweine B, Goudet V, Mercat A, Bouadma L, Lasocki S, Alfandari S, Friggeri A, Wallet F, Allou N, Ruckly S, Balayn D, Lepape A, Timsit JF; CLEAN trial investigators. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet. 2015 Nov 21;386(10008):2069-2077. doi: 10.1016/S0140-6736(15)00244-5. Epub 2015 Sep 18.
- Goudet V, Timsit JF, Lucet JC, Lepape A, Balayn D, Seguin S, Mimoz O. Comparison of four skin preparation strategies to prevent catheter-related infection in intensive care unit (CLEAN trial): a study protocol for a randomized controlled trial. Trials. 2013 Apr 27;14:114. doi: 10.1186/1745-6215-14-114.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- CLEAN
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