Instituto Dante Pazzanese de Cardiologia, Departmento de Infectologia, São Paulo, SP, Brazil.
Instituto Dante Pazzanese de Cardiologia, Departmento de Farmácia, São Paulo, SP, Brazil.
Braz J Infect Dis. 2021 Jan-Feb;25(1):101538. doi: 10.1016/j.bjid.2021.101538. Epub 2021 Jan 27.
Bathing with 2% chlorhexidine (CHG) wipes is an important measure regarding infection prevention in critically ill patients. The aim of this study was to evaluate the impact of CHG wipes bath to prevent central-line associated bloodstream infection (CLABSI) in critically ill patients and determine if such measure is cost-saving.
a quasi-experimental study, conducted from July 2017 to April 2019. Daily bath with 2% CHG was used in all patients at the unit in the intervention period. The following were evaluated: CLABSI incidence density in both periods, 30- day mortality, guided antimicrobials used to treat CLABSI and 2% CHG costs.
CLABSI incidence density dropped from 8.69 to 1.83 per 1.000 central line-days (p = 0.001), mainly by Klebsiella pneumoniae Carbapenen Resistant (Kp-KPC) (p = 0.05). Costs with guided antimicrobials for the treatment in pre-intervention were US$ 46,114.36, and in the intervention period, US$ 4,177.50. The 2% CHG monthly cost was US$ 2,698.00, achieving 30% savings when comparing both periods.
An expressive reduction of 79% in CLABSI incidence density was observed, mainly due to Kp-KPC infection and also a reduction in guided antimicrobial costs.
Bathing with 2% CHG led to evident CLABSI reduction.
用 2%洗必泰（CHG）湿巾洗澡是预防危重病患者感染的重要措施。本研究旨在评估 CHG 湿巾浴对预防重症患者中心静脉相关血流感染（CLABSI）的影响，并确定该措施是否具有成本效益。
一项准实验研究，于 2017 年 7 月至 2019 年 4 月进行。干预期间，所有患者均在该科室每天使用 2%CHG 洗澡。评估以下内容：两个时期的 CLABSI 发病率密度、30 天死亡率、用于治疗 CLABSI 的指导抗菌药物以及 2%CHG 的成本。
CLABSI 发病率密度从 8.69 降至 1.83/1000 中心静脉置管天数（p=0.001），主要是由于耐碳青霉烯类肺炎克雷伯菌（Kp-KPC）（p=0.05）。干预前指导抗菌药物治疗费用为 46114.36 美元，干预期间为 4177.50 美元。2%CHG 的月成本为 2698.00 美元，与两个时期相比，节省了 30%。
CLABSI 发病率密度显著降低了 79%，主要是由于 Kp-KPC 感染，以及指导抗菌药物成本的降低。
用 2%CHG 洗澡可明显降低 CLABSI 的发生。
