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Daily chlorhexidine bathing reduces rate of drug-resistant A. baumannii
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Daily bathing of ICU patients using washcloths treated with chlorhexidine significantly reduced carbapenem-resistant Acinetobacter baumannii acquisition and the amount of the pathogen present in the environment, according to recent research published in the American Journal of Infection Control.
“In addition to the acquisition rates of [carbapenem-resistant A. baumannii (CRAB)], the rates of CRAB contamination on the environment (especially patient-staff gowns and bed rails) were reduced significantly during the chlorhexidine bathing period,” Yun Kyung Chung, MD, PhD, from the department of occupational and environmental medicine at Hallym University Sacred Heart Hospital in Anyang, South Korea, and colleagues wrote.
Chung and colleagues performed a time series study where, from June 2012 to July 2013, they employed infection control strategies such as active surveillance culture, pre-emptive contact precautions and enhanced environmental cleaning. From August 2013 to July 2014, the researchers added daily bathing with no-rinse 2% chlorhexidine washcloths to those strategies.
They found that the incidence of CRAB decreased from 25.8% to 18.2% during the study period, with a 51.8% decrease in CRAB acquisition during the chlorhexidine bathing period (21.2 cases vs. 44 cases per 1,000 patient days; P <.001). During the chlorhexidine phase, Chung and colleagues identified a significant reduction in CRAB incidence density; however, there was no change in the prevalence of CRAB regarding level and trend. When chlorhexidine washcloths were used, the researchers noted no significant change in trend for CRAB incidence density.
For environmental cases of CRAB, the researchers found a reduction in CRAB between the infection control and chlorhexidine bathing periods, from a rate 30.7% to 9.6% (P < .001). Chung and colleagues also noted significant contamination reduction on objects such as keyboards, monitors, gowns, staff gowns and bed rails.
“Further multicenter, cluster-randomized trials will be needed to evaluate the effect of daily chlorhexidine bathing as a component of an infection prevention bundle in a CRAB endemic setting,” they wrote. – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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