BACKGROUND: Chlorhexidine gluconate (CHG) bathing has been used primarily in critical care to prevent central line-associated bloodstream infections and infections due to multidrug-resistant organisms. The objective was to determine the effect of hospital-wide CHG patient bathing on healthcare-associated infections (HAIs). DESIGN: Quasi-experimental, staged, dose-escalation study for 19 months followed by a 4-month washout period, in 3 cohorts. SETTING: Academic medical center. PATIENTS: All patients except neonates and infants. INTERVENTION AND MEASUREMENTS: CHG bathing in the form of bed basin baths or showers administered 3 days per week or daily. CHG bathing compliance was monitored, and the rate of HAIs was measured. RESULTS: Over 188,859 patient-days, 68,302 CHG baths were administered. Adherence to CHG bathing in the adult critical care units (90%) was better than that observed in other units (57.7%, [Formula: see text]). A significant decrease in infections due to Clostridium difficile was observed in all cohorts of patients during the intervention period, followed by a significant rise during the washout period. For all cohorts, the relative risk of C. difficile infection compared to baseline was 0.71 (95% confidence interval [CI], 0.57-0.89; [Formula: see text]) for 3-days-per-week CHG bathing and 0.41 (95% CI, 0.29-0.59; [Formula: see text]) for daily CHG bathing. During the washout period, the relative risk of infection was 1.85 (95% CI, 1.38-2.53; [Formula: see text]), compared to that with daily CHG bathing. A consistent effect of CHG bathing on other HAIs was not observed. No adverse events related to CHG bathing were reported. CONCLUSIONS: CHG bathing was well tolerated and was associated with a significant decrease in C. difficile infections in hospitalized patients.
BACKGROUND:Chlorhexidine gluconate (CHG) bathing has been used primarily in critical care to prevent central line-associated bloodstream infections and infections due to multidrug-resistant organisms. The objective was to determine the effect of hospital-wide CHGpatient bathing on healthcare-associated infections (HAIs). DESIGN: Quasi-experimental, staged, dose-escalation study for 19 months followed by a 4-month washout period, in 3 cohorts. SETTING: Academic medical center. PATIENTS: All patients except neonates and infants. INTERVENTION AND MEASUREMENTS: CHG bathing in the form of bed basin baths or showers administered 3 days per week or daily. CHG bathing compliance was monitored, and the rate of HAIs was measured. RESULTS: Over 188,859 patient-days, 68,302 CHG baths were administered. Adherence to CHG bathing in the adult critical care units (90%) was better than that observed in other units (57.7%, [Formula: see text]). A significant decrease in infections due to Clostridium difficile was observed in all cohorts of patients during the intervention period, followed by a significant rise during the washout period. For all cohorts, the relative risk of C. difficileinfection compared to baseline was 0.71 (95% confidence interval [CI], 0.57-0.89; [Formula: see text]) for 3-days-per-week CHG bathing and 0.41 (95% CI, 0.29-0.59; [Formula: see text]) for daily CHG bathing. During the washout period, the relative risk of infection was 1.85 (95% CI, 1.38-2.53; [Formula: see text]), compared to that with daily CHG bathing. A consistent effect of CHG bathing on other HAIs was not observed. No adverse events related to CHG bathing were reported. CONCLUSIONS:CHG bathing was well tolerated and was associated with a significant decrease in C. difficile infections in hospitalized patients.
Authors: Susan S Huang; Edward Septimus; Ken Kleinman; Julia Moody; Jason Hickok; Lauren Heim; Adrijana Gombosev; Taliser R Avery; Katherine Haffenreffer; Lauren Shimelman; Mary K Hayden; Robert A Weinstein; Caren Spencer-Smith; Rebecca E Kaganov; Michael V Murphy; Tyler Forehand; Julie Lankiewicz; Micaela H Coady; Lena Portillo; Jalpa Sarup-Patel; John A Jernigan; Jonathan B Perlin; Richard Platt Journal: Lancet Date: 2019-03-05 Impact factor: 79.321
Authors: Michael J Noto; Henry J Domenico; Daniel W Byrne; Tom Talbot; Todd W Rice; Gordon R Bernard; Arthur P Wheeler Journal: JAMA Date: 2015-01-27 Impact factor: 56.272
Authors: Irene K Louh; William G Greendyke; Emilia A Hermann; Karina W Davidson; Louise Falzon; David K Vawdrey; Jonathan A Shaffer; David P Calfee; E Yoko Furuya; Henry H Ting Journal: Infect Control Hosp Epidemiol Date: 2017-04 Impact factor: 3.254
Authors: Jin Woong Suh; Nam Hee Kim; Min Jung Lee; Seoung Eun Lee; Byung Chul Chun; Chang Kyu Lee; Juneyoung Lee; Jong Hun Kim; Sun Bean Kim; Young Kyung Yoon; Jang Wook Sohn; Min Ja Kim Journal: Antimicrob Resist Infect Control Date: 2021-11-10 Impact factor: 4.887