Daily Bathing with Chlorhexidine-Based Soap and the Prevention of Staphylococcus aureus Transmission and Infection

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Viray, Melissa A. ; Morley, James C. ; Coopersmith, Craig M ; Kollef, Marin H. ; Fraser, Victoria J. ; Warren, David K.
• 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.
  
  
• Subjects:
  Chlorhexidine Cross Infection Disinfectants Disinfection Humans Intensive Care Units Methicillin-Resistant Staphylococcus Aureus Prospective Studies Staphylococcal Infections Staphylococcus Aureus
• Source:
  Infect Control Hosp Epidemiol. 35(3):243-250.
• Pubmed ID:
  24521588
• Pubmed Central ID:
  PMC4013781
• Document Type:
  Journal Article
• 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
• Volume:
  35
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d0a68ad95e98f337369b4cc169d2e81bcb8acc4792ad8ae66395611bb0d699bdb6ed53fafb51da59aef7551931f667d1f26b3aff4e16a8206ded73042130c62d
• Download URL:
  https://stacks.cdc.gov/view/cdc/29952/cdc_29952_DS1.pdf
• File Type:
  [PDF - 372.78 KB ]