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Daily Bathing with Chlorhexidine-based Soap and the Prevention of Staphylococcus aureus Transmission and Infection
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Details:
  • Description:
    Objective

    Determine if daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and ICU-acquired S. aureus infection among ICU patients.

    Design

    Prospective pre-post-intervention study with control unit

    Setting

    1,250 bed tertiary-care teaching hospital

    Patients

    Medical and surgical intensive care unit (ICU) patients

    Methods

    Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology.

    Results

    The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol [pre-intervention 12.64 vs. post-intervention 10.03 cases/1000 patient-days-at-risk (95% CI: −5.19 – −0.04, p = 0.046)]. There was no significant change in MRSA acquisition in the control ICU during the study period [10.97 pre-June 2005 vs. 11.33/1000 patient-days at risk post-June 2005 (95% CI −37.40 – 15.19, p = 0.40)]. There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002-2007 [19.73 pre-intervention to 15.63 cases per 1000 patient-days at risk post-intervention (95% CI −7.25 – −0.95, p=0.012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 pre-intervention vs. 1.15 infections per 1000 patient-days at risk post-intervention; p=0.001).

    Conclusions

    Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infections.

  • Document Type:
  • Collection(s):
  • Funding:
    KM1 CA156708/CA/NCI NIH HHS/United States
    KM1CA156708/CA/NCI NIH HHS/United States
    U54CK000162/CK/NCEZID CDC HHS/United States
    UL1 TR000448/TR/NCATS NIH HHS/United States
    UL1 TR000448/TR/NCATS NIH HHS/United States
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