Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA.
Infect Control Hosp Epidemiol. 2012 Nov;33(11):1094-100. doi: 10.1086/668024. Epub 2012 Sep 21.
Chlorhexidine gluconate (CHG) bathing has been used primarily in critical care to prevent central line-associated bloodstream infections and infections due to multidrug-resistant organisms. The objective was to determine the effect of hospital-wide CHG patient bathing on healthcare-associated infections (HAIs).
Quasi-experimental, staged, dose-escalation study for 19 months followed by a 4-month washout period, in 3 cohorts.
Academic medical center.
All patients except neonates and infants.
CHG bathing in the form of bed basin baths or showers administered 3 days per week or daily. CHG bathing compliance was monitored, and the rate of HAIs was measured.
Over 188,859 patient-days, 68,302 CHG baths were administered. Adherence to CHG bathing in the adult critical care units (90%) was better than that observed in other units (57.7%, [Formula: see text]). A significant decrease in infections due to Clostridium difficile was observed in all cohorts of patients during the intervention period, followed by a significant rise during the washout period. For all cohorts, the relative risk of C. difficile infection compared to baseline was 0.71 (95% confidence interval [CI], 0.57-0.89; [Formula: see text]) for 3-days-per-week CHG bathing and 0.41 (95% CI, 0.29-0.59; [Formula: see text]) for daily CHG bathing. During the washout period, the relative risk of infection was 1.85 (95% CI, 1.38-2.53; [Formula: see text]), compared to that with daily CHG bathing. A consistent effect of CHG bathing on other HAIs was not observed. No adverse events related to CHG bathing were reported.
CHG bathing was well tolerated and was associated with a significant decrease in C. difficile infections in hospitalized patients.
葡萄糖酸氯己定（CHG）沐浴主要用于重症监护病房，以预防中心静脉相关血流感染和多重耐药菌感染。本研究旨在确定全院范围内 CHG 患者沐浴对医疗相关感染（HAI）的影响。
19 个月的准实验、分阶段、剂量递增研究，随后进行 4 个月的洗脱期，共 3 个队列。
学术医疗中心。
除新生儿和婴儿外的所有患者。
每周 3 天或每天进行床上盆浴或淋浴形式的 CHG 沐浴。监测 CHG 沐浴的依从性，并测量 HAI 的发生率。
在 188859 个患者日期间，共进行了 68302 次 CHG 沐浴。成人重症监护病房（ICU）的 CHG 沐浴依从性（90%）优于其他病房（57.7%，[公式：见正文]）。在干预期间，所有患者队列均观察到艰难梭菌感染显著减少，随后在洗脱期显著增加。对于所有队列，与基线相比，艰难梭菌感染的相对风险为 0.71（95%置信区间[CI]，0.57-0.89；[公式：见正文]），每周 3 天进行 CHG 沐浴，0.41（95%CI，0.29-0.59；[公式：见正文]）每日进行 CHG 沐浴。在洗脱期，感染的相对风险为 1.85（95%CI，1.38-2.53；[公式：见正文]），与每日 CHG 沐浴相比。未观察到 CHG 沐浴对其他 HAI 的一致影响。未报告与 CHG 沐浴相关的不良事件。
CHG 沐浴耐受良好，与住院患者艰难梭菌感染显著减少相关。
