Please select the eligibility criteria that correspond to the clinical trial below.
Title: Prevention of Central Venous Catheter Infections : Comparison of the Efficacy of Skin Disinfection With 5% Povidone Iodine in Alcoholic Solution Versus 0.25% Chlorhexidine, 0.025 Benzalkonium and 4% Benzylic Alcohol
Brief Summary: The best antiseptic solution for cateheter care remains unknown.High concentration in aquous solution or low concentration in alcoholic solution of chlorhexidine actbetter than povidone iodine in aquous solutions. No study has compare alcoholic formulations of low concentration of chlorhexidine and povidone iodine for skin disinfection prior to insertion of central venous catheters.

To compare the incidence of central venous catheter colonization after skin disinfection with either an alcoholic solution of povidone iodine or a combination of 0.5% chlorhexidine, 0.025% Benzalkonium and 4% benzylic alcohol.

To compare the incidence of catheter related bacteremia in the to study groups. To compare the local and general tolerance of the two antiseptic formulations


Options:
A: Inclusion Criteria:

* patients older than 18 years
* with at least a central venous catheter or an arterial catheter
* whatever the first or subsequent CVC in a same patient
* in any site of insertion (sub-clavian, jugular or femoral)
* whatever le CVC is tunnelled or not
* CVC inserted in the study ICU or immediately before by the intensisvist in the emergency unit or in the operative room,
* CVC inserted under maximal barrier precautions

Exclusion Criteria:

* pulmonary artery catheter, haemodialysis/haemodiafiltration CVCs
* known allergy to chlorhexidine
* CVC not inserted under maximal barrier precautions
* Expected duration of CVC for less than 48 hours
* CVC inserted under emergency conditions
B: Inclusion Criteria:

* Patients over 18 yeras of age
* Requiring an internal jugular or sub-clavian central venous catheter for their care during at least 72 h
* Informed consent signed up

Exclusion Criteria:

* Bacteriemic infection not under control
* extensive cutaneous infection
* Women with childbearing potential
C: Inclusion Criteria:

* Patients \>18 years
* Medical indication for CVC with a planned duration of minimum 5 days
* Patient´s (or relative´s if applicable) written informed consent

Exclusion Criteria:

* Known sensitisation against the proposed antiseptics
* Tunneled or implanted CVCs (e.g. Hickman Catheter)
* Administration of antimicrobial drugs for therapy (not prophylaxis) less than one week prior to catheterization
* Pre-existing bloodstream infection (i.e., fever and/or other signs of infection)
* Positive blood culture
* Terminal patients with limited therapy options
* Patients with burns
* Patients participating in a clinical trial on other antiseptics within a period of four weeks prior to inclusion date
* Patients with missing written consent
D: 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

Answer: B