Daily Chlorhexidine Bathing-Effect on Healthcare-associated BSI and MDRO Acquisition

Details

• Alternative Title:
  N Engl J Med
• Personal Author:
  Climo, Michael W. ; Yokoe, Deborah S. ; Warren, David K. ; Perl, Trish M. ; Bolon, Maureen ; Herwaldt, Loreen A. ; Weinstein, Robert A. ; Sepkowitz, Kent A. ; Jernigan, John A. ; Sanogo, Kakotan ; Wong, Edward S.
  More +
• Description:
  BACKGROUND ; Results of previous single center observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections (HABSIs) and acquisition of multidrug-resistant organisms (MDROs). ; METHODS ; We conducted a multicenter, cluster randomized, non-blinded crossover trial to evaluate the effect of daily bathing with chlorhexidine impregnated washcloths on the acquisition of MDROs and incidence of HABSIs. Nine intensive care and bone marrow transplant units in 6 hospitals were randomly assigned to bathe patients with either 2% no-rinse chlorhexidine-impregnated or non-antimicrobial washcloths for a six-month period, exchanged for the alternate product during the subsequent six months. The incidence rates of acquisition of MDRO and HABSI rates were compared between the two time periods by Poisson regression analysis. ; RESULTS ; A total of 7735 patients were enrolled during the study. The overall MDRO acquisition rate was 21% lower when chlorhexidine bathing was used (5.10 cases per 1000 patient days) than when non-antimicrobial washcloths were used (6.60 cases per 1000 patient days, p=0.028). The overall HABSI rate was 31% lower when chlorhexidine was used (4.45 cases per 1000 patient days) than when non-antimicrobial cloths were used (6.60 cases per 1000 patient days, p=0.007) No serious skin reactions were noted in either study period. ; CONCLUSIONS ; Daily bathing with chlorhexidine-impregnated washcloths significantly reduced the risk of acquiring MDROs and developing HABSI.
• Subjects:
  • Anti-Infective Agents, Local
  • Bacteremia
  • Baths
  • Chlorhexidine
  • Cross Infection
  • Cross-Over Studies
  • Drug Resistance, Multiple, Bacterial
  • Enterococcus
  • Gram-Positive Bacterial Infections
  • Humans
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• Keywords:
  • Staphylococcus aureus
  • Enterococcus
  • methicillin resistance
  • vancomycin resistance
  • bacteremia
  • chlorhexidine
• Source:
  N Engl J Med. 368(6):533-542
• Pubmed ID:
  23388005
• Pubmed Central ID:
  PMC5703051
• Document Type:
  Text
• Funding:
  P30 CA008748/CA/NCI NIH HHSUnited States/ ; U01 CI000395/CI/NCPDCID CDC HHSUnited States/ ; 5U01C1000395-02/PHS HHSUnited States/
• Genre:
  Journal Article
• Volume:
  368
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/50395/cdc_50395_DS1.pdf
• File Type:
  [PDF - 469.29 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:a192fdefd4797fb53c95a176f250946abb5d21b9750a72fc52b32824b015351ec29a9dcb5ddd9ecd284fa3bd4b33204bd8eee175f05240629ab5a417a472d372