Major ArticleImplementation of daily chlorhexidine bathing to reduce colonization by multidrug-resistant organisms in a critical care unit
Section snippets
Study design
Between May 2010 and January 2011, a quasiexperimental, pretest–posttest study was carried out as a quality improvement project. On June 14, 2010, our hospital began daily CHG bathing of all patients in the critical care unit. We collected samples for microbiologic testing (nasal, skin, oral, and stool) pre- and postimplementation of daily CHG bathing. During both the pre- and post-implementation periods, we collected admission and discharge surveillance samples, stored them, and later (April
Results
Of the 619 patients in this study, 463 (74.8%) were admitted during the postintervention period and contributed 5,608 patient days compared with 882 for the preintervention period. The median age, median length of stay, and race did not differ between the pre- and postimplementation periods, but there were more men in the postimplementation period (Table 1).
The prevalence of VRE, FQRGNB, and that of a composite outcome (MRSA, VRE, and/or FQRGNB) at the first admission to the ICU was higher
Discussion
Here, we provide a descriptive analysis of MDRO colonization following real-world application of daily CHG bathing.
With the exception of MRSA, we observed an initial decrease in the trend of the prevalence and incidence of MDROs immediately following implementation of daily CHG bathing. The prevalence was higher than the incidence during most months after the intervention, but this was not consistent throughout the entire postimplementation period.
The initial decrease in the incidence and
Conclusions
Prevalence of MDROs decreased during the immediate aftermath, but generally remained at that level throughout the postimplementation period. The incidence of MDROs remained low and constant over the observation period. Health care facilities need to identify and address factors that might influence the long-term sustainability of the effects of daily CHG bathing. Moreover, in light of the recent Food and Drug Administration warning about rare but serious allergic reactions to CHG,22 health care
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Cited by (15)
Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities
2021, Journal of Hospital InfectionCitation Excerpt :Further evidence came from eighteen UBA studies [117–134] which used CHG either in combination or alone. These other studies showed heterogenous results with 11 studies reporting a benefit [118,120–124,128,130–132,134] and seven reporting no significant change. [117,119,125–127,129,133]. There was inconsistent evidence from two RCTs [86,95] which assessed the effectiveness of CHG mouth rinse on the presence of MRSA in the oral cavity in patients admitted to ICUs.
Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units
2021, Journal of the Formosan Medical AssociationCitation Excerpt :Daily bathing with 2% CHG is a simple and highly effective intervention to decolonize the skin and prevent catheter-associated bloodstream infections at ICUs or hematological units.10–15 CHG bathing has been shown to decrease VRE acquisition.13,14,16 However, its effect on VRE-HAIs has not been assessed in prospective studies at ICUs.17,18
Is it cost effective to use a 2% chlorhexidine wipes bath to reduce central-line associated blood stream infection? A quasi-experimental study
2021, Brazilian Journal of Infectious DiseasesCitation Excerpt :Studies indicate an attributed mortality of CLABSI to be 2.27–2.75%,3,4 reaching up to 34% if the infection is caused by carbapenem resistant Klebsiella pneumoniae.5 Several studies have shown that bathing with 2% chlorhexidine (CHG) wipes is an important preventive measure of infection in critically ill patients, mainly of CLABSI.6–11 Previous studies also support the use of CHG bathing as a cost-saving practice.
Response to Aho Glele et al.
2018, Journal of Hospital InfectionHow Does Time Affect the Antimicrobial Activity of Super-Oxidized Commercial Antiseptic Solutions? An In Vitro Test
2023, Microbial Drug ResistanceChlorhexidine bathing reduces vancomycin-resistant enterococci (VRE) in intensive care units
2022, Hygiene + Medizin
Supported by grant No. R18HS024039 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Conflicts of interest: None to report.