Duszyńska Wiesława, Adamik Barbara, Lentka-Bera Karolina, Kulpa Katarzyna, Nieckula-Schwarz Agata, Litwin Agnieszka, Stróżecki Łukasz, Kübler Andrzej
Department of Anaesthesiology and Intensive Therapy, Wrocław Medical University, Wrocław, Poland.
Anaesthesiol Intensive Ther. 2017;49(1):28-33. doi: 10.5603/AIT.2017.0007.
Healthcare-associated infections (HAIs), particularly intensive care unit-acquired infections (HAI-ICU), are an important cause of morbidity and mortality in hospitals. Most of these infections are caused by multidrugresistant organisms. The results of recent studies have suggested that daily bathing with chlorhexidine (CHX)-universal decolonisation can prevent ICU infections. The purpose of the study was to determine the influence of CHX bathing on the rate and type of HAI-ICU in critically ill patients.
This observational study, conducted in a mixed, 16-bed tertiary ICU, compared the following three 3-month periods: I) pre-intervention (traditional soap-water bathing), II) intervention (bathing with 2% CHX clothes), and III) post-intervention (soap-water bathing). The type and rate of HAI-ICU were registered according to the European Centre for Disease Prevention and Control (ECDC) guidelines.
A total of 272 patients were included in the study. During the intervention period, the total infection rate was significantly lower than in the pre-intervention period (12.7% vs 22.2%, respectively). Significant decreases in the rate and density of catheter-related infections (CRI) were observed during the intervention period. A decrease in the isolation rate of multidrug-resistant bacteria was also observed during the intervention and post-intervention periods.
Daily bathing of ICU patients with chlorhexidine-impregnated clothes significantly decreased the rate of HAI-ICU and the acquisition of CRI. This simple hygienic approach can be an important adjunctive intervention with the capability of reducing the burden of healthcare-associated infections in ICUs.
医疗保健相关感染（HAIs），尤其是重症监护病房获得性感染（HAI-ICU），是医院发病和死亡的重要原因。这些感染大多由多重耐药菌引起。最近的研究结果表明，使用洗必泰（CHX）进行每日全身去定植沐浴可预防重症监护病房感染。本研究的目的是确定洗必泰沐浴对重症患者HAI-ICU的发生率和类型的影响。
本观察性研究在一家拥有16张床位的综合性三级重症监护病房进行，比较了以下三个为期3个月的时间段：I）干预前（传统肥皂水沐浴），II）干预期（使用2%洗必泰衣物沐浴），III）干预后（肥皂水沐浴）。根据欧洲疾病预防控制中心（ECDC）指南记录HAI-ICU的类型和发生率。
共有272例患者纳入研究。在干预期，总感染率显著低于干预前期（分别为12.7%和22.2%）。在干预期观察到导管相关感染（CRI）的发生率和密度显著降低。在干预期和干预后期也观察到多重耐药菌的分离率下降。
使用含洗必泰的衣物对重症监护病房患者进行每日沐浴可显著降低HAI-ICU的发生率和CRI的获得率。这种简单的卫生方法可以作为一种重要的辅助干预措施，有能力减轻重症监护病房医疗保健相关感染的负担。
