Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T13:45:22.887Z Has data issue: false hasContentIssue false

Hospital Basins Used to Administer Chlorhexidine Baths Are Unlikely Microbial Reservoirs

Published online by Cambridge University Press:  02 January 2015

Mark E. Rupp*
Affiliation:
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska Department of Infection Control and Epidemiology, Nebraska Medical Center, Omaha, Nebraska
Tomas Huerta
Affiliation:
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Stephanie Yu
Affiliation:
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
R. Jennifer Cavalieri
Affiliation:
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Roxanne Alter
Affiliation:
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
Paul D. Fey
Affiliation:
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
Elizabeth Lyden
Affiliation:
Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Trevor Van Schooneveld
Affiliation:
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska Department of Infection Control and Epidemiology, Nebraska Medical Center, Omaha, Nebraska
*
984031 Nebraska Medical Center, Omaha, NE 68198 ([email protected])

Extract

Basins, commonly used to bathe patients who are unable to bathe themselves, frequently become contaminated with potential pathogens and may serve as a source for nosocomial transmission. Chlorhexidine (CHG) has bactericidal activity against a broad spectrum of pathogens and is increasingly used in antiseptic patient baths. The purpose of this study was to ascertain whether basins used to administer CHG bed baths are likely to become contaminated.

Bed bath conditions were simulated by mixing 30 mL of a 4% CHG product or soap preparation to 1 L of warm (37°C) tap water in a 6-L plastic basin (Medical Action Industries). Two commercial brands of CHG (Hibiclens, Molnlycke Health Care [hereafter, CHG-A], or Scrub Care, Cardinal Health [hereafter, CHG-B]) and 1 brand of soap (SensiCare SeptiSoft, ConvaTec) were used. Basins were inoculated with 108 colony-forming units (CFUs) of 1 species of bacteria, mixed for 30 seconds, incubated for 20 minutes at room temperature, emptied, and allowed to dry for 1 hour. A 100-cm2 area on the bottom of the basin was sampled for 10 seconds in 2 directions with a cotton swab premoistened with normal saline. Swab tips were placed in 2 mL of trypticase soy broth (Difco) and vortex-mixed for 30 seconds, and the solution was quantitatively cultured on sheep blood agar (Remel). Cultures were incubated at 37°C for 24 hours, and colonies were counted and expressed as CFUs per square centimeter. Tap water with and without a bacterial inoculum served as positive and negative controls, respectively.

Type
Research Briefs
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Marchaim, D, Taylor, AR, Hayakawa, K, et al.Hospital basins are frequently contaminated with multidrug-resistant human pathogens. Am J Infect Control 2012;40:562564.CrossRefGoogle ScholarPubMed
2.Johnson, D, Lineweaver, L, Maze, LM. Patients' bath basins as potential sources of infection: a multicenter sampling study. Am J Crit Care 2009;18(1):3140.CrossRefGoogle ScholarPubMed
3.McGuckin, M, Shubin, A, Hujcs, M. Intervential patient hygiene model: infection control and nursing share responsibility for patient safety. Am J Infect Control 2008;36(1)5962.CrossRefGoogle Scholar
4.Milstone, AM, Passaretti, CL, Perl, TM. Chlorhexidine: expanding the armamentarium for infection control and prevention. Clin Infect Dis 2008;46(2):274281.Google ScholarPubMed
5.Bleasdale, SC, Trick, WE, Gonzalez, IM, Lyles, RD, Hayden, MK, Weinstein, RA. Effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical intensive care unit patients. Arch Intern Med 2007;167(19):20732079.CrossRefGoogle ScholarPubMed
6.Climo, MW, Sepkowitz, KA, Zuccotti, G, et al.The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: results of a quasi-experimental multicenter trial. Crit Care Med 2009;37(6):18581865.CrossRefGoogle ScholarPubMed
7.Rupp, ME, Cavalieri, RJ, Lyden, E, et al.Effect of hospital-wide chlorhexidine patient bathing on healthcare-associated infections. Infect Control Hosp Epidemiol 2012;33(11):10941100.CrossRefGoogle ScholarPubMed
8.Batra, R, Cooper, BS, Shiteley, C, Patel, AK, Wyncoll, D, Edgeworth, JD. Efficacy and limitation of a chlorhexidine-based decolonization strategy in preventing transmission of methicillin-resistant Staphylococcus aureus in an intensive care unit. Clin Infect Dis 2010;50(2):210217.CrossRefGoogle Scholar
9.Horner, C, Mawer, D, Wilcox, M. Reduced susceptibility to chlorhexidine in staphylococci: is it increasing and does it matter? J Antimicrob Chemother 2012;56:25472559.CrossRefGoogle Scholar
10.Smith, K, Gemmell, CG, Hunter, IS. The association between biocide tolerance and presence or absence of qac genes among hospital-acquired and community-acquired MRSA isolates. J Antimicrob Chemother 2008;61:7884.CrossRefGoogle ScholarPubMed