Impact of chlorhexidine bathing on hospital-acquired infections among general medical patients

Steven Kassakian, Leonard A. Mermel, Julie A. Jefferson, Stephen L. Parenteau, Jason T. Machan

Research output: Contribution to journalArticle

52 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)238-243
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume32
Issue number3
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

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Chlorhexidine
Cross Infection
Methicillin-Resistant Staphylococcus aureus
Vancomycin
Soaps
Clostridium difficile
Incidence
Control Groups
Water
Tertiary Healthcare
Inpatients
Research Design
Medicine
chlorhexidine gluconate

ASJC Scopus subject areas

  • Microbiology (medical)
  • Epidemiology
  • Infectious Diseases

Cite this

Impact of chlorhexidine bathing on hospital-acquired infections among general medical patients. / Kassakian, Steven; Mermel, Leonard A.; Jefferson, Julie A.; Parenteau, Stephen L.; Machan, Jason T.

In: Infection Control and Hospital Epidemiology, Vol. 32, No. 3, 01.03.2011, p. 238-243.

Research output: Contribution to journalArticle

Kassakian, Steven ; Mermel, Leonard A. ; Jefferson, Julie A. ; Parenteau, Stephen L. ; Machan, Jason T. / Impact of chlorhexidine bathing on hospital-acquired infections among general medical patients. In: Infection Control and Hospital Epidemiology. 2011 ; Vol. 32, No. 3. pp. 238-243.
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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.",
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