葡萄糖酸洗必泰沐浴对入住新生儿重症监护病房新生儿皮肤细菌负荷的影响。
The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit.
机构信息
Department of Pediatrics, Division of Neonatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Pathology, Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
J Perinatol. 2019 Jan;39(1):63-71. doi: 10.1038/s41372-018-0231-7. Epub 2018 Sep 20.
OBJECTIVE
To assess the impact of chlorhexidine gluconate (CHG) bathing on skin bacterial burden in neonates.
STUDY DESIGN
In this prospective observational study, arm and groin skin bacterial growth was measured in 40 CHG-exposed and nonexposed neonates admitted to the NICU. Exposed neonates received 2% CHG baths per protocol for central line-associated bloodstream infection (CLABSI) prevention or Staphylococcus aureus decolonization.
RESULTS
Forty neonates were enrolled, 18 of whom were CHG-exposed. Mean baseline Gram-positive (GP) bacterial burden was 2.19 log CFU/ml on the arm and 1.81 log CFU/ml on the groin. Bacterial burden decreased after the first bath, but returned to baseline by 72 h. Residual skin CHG concentration declined over time, with a corresponding increase in GP bacterial burden.
CONCLUSIONS
CHG bathing reduces skin bacterial burden, but burden returns to baseline after 72 h. Twice weekly CHG bathing may be inadequate to suppress skin bacterial growth in hospitalized neonates.
目的
评估葡萄糖酸氯己定（CHG）沐浴对新生儿皮肤细菌负担的影响。
研究设计
在这项前瞻性观察研究中，对入住新生儿重症监护病房（NICU）的 40 名接受 CHG 暴露和未暴露的新生儿的手臂和腹股沟皮肤细菌生长进行了测量。暴露的新生儿根据预防中心静脉相关血流感染（CLABSI）或金黄色葡萄球菌去定植的方案接受 2% CHG 沐浴。
结果
共纳入 40 名新生儿，其中 18 名接受 CHG 暴露。手臂上的革兰阳性（GP）细菌负荷的基线平均值为 2.19 log CFU/ml，腹股沟处为 1.81 log CFU/ml。第一次沐浴后细菌负荷减少，但在 72 小时后恢复到基线。随着时间的推移，皮肤残留 CHG 浓度下降，GP 细菌负荷相应增加。
结论
CHG 沐浴可降低皮肤细菌负担，但 72 小时后负担会恢复到基线。每周两次的 CHG 沐浴可能不足以抑制住院新生儿的皮肤细菌生长。
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