Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection
Top Cited Papers
- 7 February 2013
- journal article
- research article
- Published by Massachusetts Medical Society in The New England Journal of Medicine
- Vol. 368 (6), 533-542
- https://doi.org/10.1056/nejmoa1113849
Abstract
BACKGROUND Results of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs). METHODS We conducted a multicenter, cluster-randomized, nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections. Nine intensive care and bone marrow transplantation units in six hospitals were randomly assigned to bathe patients either with no-rinse 2% chlorhexidine-impregnated washcloths or with nonantimicrobial washcloths for a 6-month period, exchanged for the alternate product during the subsequent 6 months. The incidence rates of acquisition of MDROs and the rates of hospital-acquired bloodstream infections were compared between the two periods by means of Poisson regression analysis. RESULTS A total of 7727 patients were enrolled during the study. The overall rate of MDRO acquisition was 5.10 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P = 0.03), the equivalent of a 23% lower rate with chlorhexidine bathing. The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P = 0.007), a 28% lower rate with chlorhexidine-impregnated washcloths. No serious skin reactions were noted during either study period. CONCLUSIONS Daily bathing with chlorhexidine-impregnated washcloths significantly reduced the risks of acquisition of MDROs and development of hospital-acquired bloodstream infections. (Funded by the Centers for Disease Control and Prevention and Sage Products; ClinicalTrials.gov number, NCT00502476.)Keywords
This publication has 34 references indexed in Scilit:
- Distribution of Antiseptic Resistance Genes qacA, qacB , and smr in Methicillin-Resistant Staphylococcus aureus Isolated in Toronto, Canada, from 2005 to 2009Antimicrobial Agents and Chemotherapy, 2011
- The relevance of chlorhexidine contact allergyContact Dermatitis, 2011
- Chlorhexidine-Methanol Burns in Two Extreme Preterm NewbornsPediatric Dermatology, 2010
- Costs Attributable to Healthcare-Acquired Infection in Hospitalized Adults and a Comparison of Economic MethodsMedical Care, 2010
- Epidemiology and susceptibilities of methicillin-resistant Staphylococcus aureus in Taiwan: emphasis on chlorhexidine susceptibilityDiagnostic Microbiology and Infectious Disease, 2009
- Hospitals asked to account for errors on their watch. CMS and states may stop paying for specific hospital-acquired conditions. Will health plans follow suit?2007
- Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threatThe Lancet, 2006
- Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital*Critical Care Medicine, 2006
- Chlorhexidine Gluconate to Cleanse Patients in a Medical Intensive Care UnitArchives of Internal Medicine, 2006
- Assessment of pathogen occurrences and resistance profiles among infected patients in the intensive care unit: report from the SENTRY Antimicrobial Surveillance Program (North America, 2001)International Journal of Antimicrobial Agents, 2004