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Chlorhexidine washcloths reduced risk for MDR organisms in ICU
Using chlorhexidine washcloths daily to bathe patients reduced the risk for multidrug-resistant organisms and hospital-acquired bloodstream infections, according to recent data.
“Because hospital-acquired bloodstream infections often result from the ingress of skin organisms into the bloodstream along vascular catheters or other breaks in skin integrity, skin decontamination could theoretically also decrease the risk of infection,” the researchers wrote in The New England Journal of Medicine. “Previous studies of bathing with chlorhexidine have been primarily single-center, before-and-after, observational studies, with limited general applicability of results.”
The current study was a multicenter, cluster-randomized crossover study that included 7,727 patients in nine ICUs or bone marrow transplantation units from six hospitals. The units were randomly assigned to bathe patients with washcloths impregnated with 2% chlorhexidine or non-antimicrobial washcloths for 6 months. In the following 6 months, the alternate bathing product was used.
During the chlorhexidine bathing periods, the overall rate of methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci acquisition was 23% lower than the bathing periods with the non-antimicrobial washcloths. For those who used chlorhexidine cloths, the rate was 5.1 cases per 1,000 patient-days vs. 6.6 cases per 1,000 patient-days for non-antimicrobial cloths.
During the chlorhexidine bathing period, there were 119 hospital-acquired bloodstream infections compared with 165 during the non-antimicrobial cloth bathing period. The rate was 28% lower during the chlorhexidine period. The rate of central catheter-associated bloodstream infections was 53% lower during the chlorhexidine period.
“Identifying simple, cost-effective and safe strategies for the prevention of health care-associated infection is essential,” the researchers wrote. “Daily bathing with chlorhexidine-impregnated washcloths is a strategy that is relatively straightforward to implement and sustain because it does not require a substantial change from patient-bathing practices that are currently routine.”
Disclosure: See the study for a full list of financial disclosures.