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Impact of Chlorhexidine Bathing on Hospital-Acquired Infections among General Medical Patients

  • Steven Z. Kassakian (a1), Leonard A. Mermel (a1) (a2), Julie A. Jefferson (a2) (a3), Stephen L. Parenteau (a2) and Jason T. Machan (a4)...

Abstract

Background.

A paucity of data exists regarding the effectiveness of daily Chlorhexidine gluconate (CHG) bathing in non–intensive care unit (ICU) settings.

Objective.

To evaluate the effectiveness of daily CHG bathing in a non-ICU setting to reduce methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enteroccocus (VRE) hospital-acquired infections (HAIs), compared with daily bathing with soap and water.

Design.

Quasi-experimental study design; the primary outcome was the composite incidence of MRSA and VRE HAIs. Clostridium difficile HAI incidence was measured as a nonequivalent dependent variable with which to assess potential confounders.

Setting.

Four general medicine units, with a total of 94 beds, at a 719-bed academic tertiary-care facility in Providence, Rhode Island.

Patients.

A total of 7,102 and 7,699 adult patients were admitted to the medical service in the control and intervention groups, respectively. Patients admitted from January 1 through December 31, 2008, were bathed daily with soap and water (control group), and those admitted from February 1, 2009, through March 31, 2010, were bathed daily with CHG-impregnated cloths (intervention group).

Results.

Daily bathing with CHG was associated with a 64% reduced risk of developing the primary outcome, namely, the composite incidence of MRSA and VRE HAIs (hazard ratio, 0.36 [95% CI, 0.2-0.8]; P = .01). There was no change in the incidence of C. difficile HAIs (P = .6). Colonization with MRSA was associated with an increased risk of developing a MRSA HAI (hazard ratio, 8 [95% CI, 3-19]; P < .001).

Conclusion.

Daily CHG bathing was associated with a reduced HAI risk, using a composite endpoint of MRSA and VRE HAIs, in a general medical inpatient population.

Copyright

Corresponding author

Division of Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 (lmermel@lifespan.org)

References

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