Journal article
Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection
The New England journal of medicine, Vol.368(6), pp.533-542
2013
DOI: 10.1056/NEJMoa1113849
PMID: 23388005
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.
Details
- Title: Subtitle
- Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection
- Creators
- Michael W CLIMO - Hunter Holmes McGuire Veterans Affairs Medical Center, United StatesLoreen A HERWALDT - Iowa University Hospital, Iowa City, United StatesDeborah S YOKOE - Brigham and Women's Hospital and Harvard Medical School, Boston, United StatesEdward S WONG - Hunter Holmes McGuire Veterans Affairs Medical Center, United StatesDavid K WARREN - Washington University School of Medicine, St. Louis, United StatesTrish M PERL - Johns Hopkins University, Baltimore, United StatesMaureen BOLON - Northwestern University, United StatesRobert A Weinstein - Cook County Health and Hospitals System, Chicago, United StatesKent A SEPKOWITZ - Memorial Sloan-Kettering Cancer Center, New York, United StatesJohn A JERNIGAN - Prevention Epicenters Program, Centers for Disease Control and Prevention, Atlanta, United StatesKakotan SANOGO - Virginia Commonwealth University Medical Center, Richmond, United States
- Resource Type
- Journal article
- Publication Details
- The New England journal of medicine, Vol.368(6), pp.533-542
- Publisher
- Massachusetts Medical Society
- DOI
- 10.1056/NEJMoa1113849
- PMID
- 23388005
- ISSN
- 0028-4793
- eISSN
- 1533-4406
- Language
- English
- Date published
- 2013
- Academic Unit
- Infectious Diseases; Epidemiology; Internal Medicine
- Record Identifier
- 9984094670602771
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