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.).
RCT Entities:
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.).
Authors: Rebecca R Roberts; R Douglas Scott; Bala Hota; Linda M Kampe; Fauzia Abbasi; Shari Schabowski; Ibrar Ahmad; Ginevra G Ciavarella; Ralph Cordell; Steven L Solomon; Reidar Hagtvedt; Robert A Weinstein Journal: Med Care Date: 2010-11 Impact factor: 2.983
Authors: David K Warren; Wasim W Quadir; Christopher S Hollenbeak; Alexis M Elward; Michael J Cox; Victoria J Fraser Journal: Crit Care Med Date: 2006-08 Impact factor: 7.598
Authors: Melissa A Viray; James C Morley; Craig M Coopersmith; Marin H Kollef; Victoria J Fraser; David K Warren Journal: Infect Control Hosp Epidemiol Date: 2014-01-24 Impact factor: 3.254
Authors: Anthony D Harris; Lisa Pineles; Beverly Belton; J Kristie Johnson; Michelle Shardell; Mark Loeb; Robin Newhouse; Louise Dembry; Barbara Braun; Eli N Perencevich; Kendall K Hall; Daniel J Morgan; Syed K Shahryar; Connie S Price; Joseph J Gadbaw; Marci Drees; Daniel H Kett; L Silvia Muñoz-Price; Jesse T Jacob; Loreen A Herwaldt; Carol A Sulis; Deborah S Yokoe; Lisa Maragakis; Matthew E Lissauer; Marcus J Zervos; David K Warren; Robin L Carver; Deverick J Anderson; David P Calfee; Jason E Bowling; Nasia Safdar Journal: JAMA Date: 2013-10-16 Impact factor: 56.272
Authors: C Camus; V Sebille; A Legras; B Garo; A Renault; P Le Corre; P-Y Donnio; A Gacouin; D Perrotin; Y Le Tulzo; E Bellissant Journal: Infection Date: 2014-01-25 Impact factor: 3.553