Please select the eligibility criteria that correspond to the clinical trial below.
Title: Skin Disinfection With Octenidine Dihydrochloride for the Prevention of Catheter-Associated Infections - A Double-Blind, Randomized, Controlled Trial
Brief Summary: Health-care-acquired infections are of tremendous importance for patients, especially catheter-associated infections. More than 40% of all bloodstream infections are associated with central venous catheters (CVC; catheters which are inserted into a large vein near the heart). Of all patients that acquire such an infection 1% to 5% die as a result from it. The insertion site is the main source of contamination and infection. In general, bacteria of the skin are the cause of infection, especially in short-term CVCs (10-14 days). Therefore it is necessary to efficiently disinfect the skin for the preparation and care of CVC insertion sites. Several substances are used for disinfection. Alcohol-based disinfectants are mainly used in Central Europe, other preparations contain povidine-iodine or chlorhexidine. Alcoholic disinfectants have a rapid initial effect, chlorhexidine shows an additional remanent (longer lasting) effect. A further substance, octenidine dihydrochloride, also demonstrated a remanent effect in a pilot study with neurosurgical patients. The purpose of our study is to compare an alcohol-based disinfectant containing octenidine dihydrochloride with a pure alcoholic disinfectant regarding efficacy and tolerability in patients receiving a CVC for a minimum of 5 days.


Options:
A: 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
B: 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
C: 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
D: 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

Answer: A