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Impact of Chlorhexidine Bathing on Hospital-Acquired Infections among General Medical Patients

Published online by Cambridge University Press:  02 January 2015

Steven Z. Kassakian ,
Leonard A. Mermel ,
Julie A. Jefferson ,
Stephen L. Parenteau  and
Jason T. Machan
Steven Z. Kassakian
Affiliation:
Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
Leonard A. Mermel*
Affiliation:
Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island Department of Epidemiology and Infection Control, Rhode Island Hospital, Providence, Rhode Island
Julie A. Jefferson
Affiliation:
Department of Epidemiology and Infection Control, Rhode Island Hospital, Providence, Rhode Island Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island
Stephen L. Parenteau
Affiliation:
Department of Epidemiology and Infection Control, Rhode Island Hospital, Providence, Rhode Island
Jason T. Machan
Affiliation:
Department of Orthopaedics and Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
*
Division of Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 ([email protected])
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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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 3 , March 2011 , pp. 238 - 243
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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