The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology

Abstract Background 2% Chlorhexidine gluconate in a 70% alcohol solution is considered the gold standard for skin disinfection in adult and paediatric patients prior to insertion of a central venous catheter. The use of chlorhexidine gluconate in infants remains controversial due to concerns about p...

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Main Authors: Vito D’Andrea, Antonella Capasso, Carmen Rodriguez-Perez, Francesca Tota, Rossella Mastroianni, Giorgia Prontera, Giovanni Barone
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-02016-5
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author Vito D’Andrea
Antonella Capasso
Carmen Rodriguez-Perez
Francesca Tota
Rossella Mastroianni
Giorgia Prontera
Giovanni Barone
author_facet Vito D’Andrea
Antonella Capasso
Carmen Rodriguez-Perez
Francesca Tota
Rossella Mastroianni
Giorgia Prontera
Giovanni Barone
author_sort Vito D’Andrea
collection DOAJ
description Abstract Background 2% Chlorhexidine gluconate in a 70% alcohol solution is considered the gold standard for skin disinfection in adult and paediatric patients prior to insertion of a central venous catheter. The use of chlorhexidine gluconate in infants remains controversial due to concerns about potential risks of skin injury such as chemical burns, contact dermatitis and systemic absorption. The objective of this survey is to investigate the practice of skin disinfection with 2% chlorhexidine gluconate in 70% isopropyl alcohol prior to central venous catheterization in infants in Italy. Methods Over a one-year period, we conducted an online survey in 114 neonatal intensive care units on the use of skin antiseptics for central venous catheters in neonates. Results Sixty-five percent of the centers use a 2% chlorhexidine solution in a 70% alcohol solution for skin disinfection before inserting central catheters in neonates. Ten percent use povidone-iodine, and two percent use sodium hypochlorite. Among those using alcoholic chlorhexidine, sixty-five percent use it without any restrictions, thirty percent limit its use based on the gestational age of the neonate, and five percent limit it based on the neonatal weight. Thirty-seven percent of the centers rinse off the chlorhexidine solution due to concerns about chemical injuries. Conclusions The survey revealed that there’s still a lack of uniformity in the use of skin disinfectants before central catheter placement. The Neonatal Vascular Access Group (AVN GdS) of the Italian Society of Neonatology reiterates the use of 2% chlorhexidine in a 70% alcohol solution for skin disinfection before central catheter insertion, as recommended by recent guidelines. However, specific precautions must be taken to avoid complications.
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spelling doaj-art-ff128766c00b4fa986dcd887f962fbdd2025-08-20T03:10:34ZengBMCItalian Journal of Pediatrics1824-72882025-06-015111510.1186/s13052-025-02016-5The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of NeonatologyVito D’Andrea0Antonella Capasso1Carmen Rodriguez-Perez2Francesca Tota3Rossella Mastroianni4Giorgia Prontera5Giovanni Barone6Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCSNeonatology and Neonatal Intensive Care Unit, A.O.U. Federico 2Neonatology and Neonatal Intensive Care Unit, ASST Spedali Civili, Ospedale Dei BambiniNeonatal Intensive Care Unit, Ospedale S. Chiara, APSSNeonatal Intensive Care Unit, S. Anna E S. Sebastiano HospitalNeonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCSNeonatal Intensive Care Unit, Infermi Hospital, Rimini, AUSL RomagnaAbstract Background 2% Chlorhexidine gluconate in a 70% alcohol solution is considered the gold standard for skin disinfection in adult and paediatric patients prior to insertion of a central venous catheter. The use of chlorhexidine gluconate in infants remains controversial due to concerns about potential risks of skin injury such as chemical burns, contact dermatitis and systemic absorption. The objective of this survey is to investigate the practice of skin disinfection with 2% chlorhexidine gluconate in 70% isopropyl alcohol prior to central venous catheterization in infants in Italy. Methods Over a one-year period, we conducted an online survey in 114 neonatal intensive care units on the use of skin antiseptics for central venous catheters in neonates. Results Sixty-five percent of the centers use a 2% chlorhexidine solution in a 70% alcohol solution for skin disinfection before inserting central catheters in neonates. Ten percent use povidone-iodine, and two percent use sodium hypochlorite. Among those using alcoholic chlorhexidine, sixty-five percent use it without any restrictions, thirty percent limit its use based on the gestational age of the neonate, and five percent limit it based on the neonatal weight. Thirty-seven percent of the centers rinse off the chlorhexidine solution due to concerns about chemical injuries. Conclusions The survey revealed that there’s still a lack of uniformity in the use of skin disinfectants before central catheter placement. The Neonatal Vascular Access Group (AVN GdS) of the Italian Society of Neonatology reiterates the use of 2% chlorhexidine in a 70% alcohol solution for skin disinfection before central catheter insertion, as recommended by recent guidelines. However, specific precautions must be taken to avoid complications.https://doi.org/10.1186/s13052-025-02016-5Skin disinfectionChlorhexidine gluconateCentral line bloodstream infectionsPremature infants
spellingShingle Vito D’Andrea
Antonella Capasso
Carmen Rodriguez-Perez
Francesca Tota
Rossella Mastroianni
Giorgia Prontera
Giovanni Barone
The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology
Italian Journal of Pediatrics
Skin disinfection
Chlorhexidine gluconate
Central line bloodstream infections
Premature infants
title The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology
title_full The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology
title_fullStr The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology
title_full_unstemmed The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology
title_short The use of 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to central venous catheterization in infants: a national survey of the Italian Society of Neonatology
title_sort use of 2 chlorhexidine gluconate in 70 isopropyl alcohol for skin disinfection prior to central venous catheterization in infants a national survey of the italian society of neonatology
topic Skin disinfection
Chlorhexidine gluconate
Central line bloodstream infections
Premature infants
url https://doi.org/10.1186/s13052-025-02016-5
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