Skin Decolonization of Children Hospitalized in Intensive Care Unit
Condition: Central Venous Catheter
Study type: Observational

Summary: 
      The purpose of this study is to evaluate the efficacy and duration of the skin decolonization
      brought by a daily wash using Chlorhexidine Gluconate 2% pad compared to a standard wash with
      mild soap in children hospitalized in intensive care unit.
    

Detailed description: 
      Skin is a major reservoir of pathogenic bacteria and intensive care unit patients are
      particularly vulnerable to variations in skin colonization and so to infections. These
      bacterial skin colonizations can contaminate other patients, nursing staff or even samples,
      but above all they are an endogenous source of infection of material. These bacterial skin
      colonizations hold therefore a major place in the responsibility of infections associated
      with care and can potentially affect the length of patient hospitalization. 2% Chlorhexidine
      Gluconate pads have already demonstrated a real efficacy in the sustainable reduction of
      central venous catheter-related bacteremias in adults and in children, probably through a
      reduction of cutaneous microbial colonization. However, this hypothesis remains to be
      confirmed.

      Patients in the pediatric surgical intensive care unit of Necker-Enfants Malades hospital are
      minors, hospitalized in critical and continuous surgical surveillance unit, for all surgical
      specialties excluding cardiac surgery. The use of central venous catheters concerns
      approximately 60% of the hospitalization days identified each year. To control
      catheter-related bacteremias, all intensive care unit patients are subjected to a service
      protocol since 2015, which defines a mild soap daily wash in patients without central venous
      catheter and a wash with Chlorhexidine in patients with central venous catheter. Successive
      standardized samples will be carried out on the skin of the children submissive to both types
      of washes during their hospitalization in intensive care unit.
    

Intervention name(s): Skin microbiological sampling (wash with 2% Chlorhexidine Gluconate); Skin microbiological sampling (wash with mild soap)
Intervention type(s): Other; Other
Intervention description(s): 3 microbiological samples, per application of agar on skin, after 24h of a first wash with 2% Chlorhexidine Gluconate : 1h before the second wash with the same washing product and then 1 to 2 h after, and 20 to 23h after this second wash.; 3 microbiological samples, per application of agar on skin, after 24h of a first wash with mild soap : 1h before the second wash with the same washing product and then 1 to 2 h after, and 20 to 23h after this second wash.
Other intervention name(s): Skin microbiological sampling; Skin microbiological sampling
Intervention MeSH terms: Chlorhexidine; Chlorhexidine gluconate
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Minors hospitalized in intensive care unit of Necker Hospital.
      
Keywords: Central venous catheter-related bacteremias; Skin decolonization; Intensive care unit hospitalization