Chang Hsu-Liang, Liu Tzu-Ying, Huang Po-Shou, Chen Chin-Hwan, Yen Chia-Wen, Chen Hui-Zhu, Kuo Shin-Huei, Chen Tun-Chieh, Lin Shang-Yi, Lu Po-Liang
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan.
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Microorganisms. 2025 Jan 2;13(1):65. doi: 10.3390/microorganisms13010065.
Healthcare-associated infections (HAIs) significantly increase morbidity, mortality, length of hospital stays, and costs, particularly among ICU patients. Despite standard interventions, catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) remain major HAI contributors. This study evaluated the efficacy of daily 2% chlorhexidine gluconate (CHG) bathing in reducing HAI incidence, specifically CAUTI, CLABSI, and multidrug-resistant organisms (MDROs), in a 20-bed ICU at a regional hospital. Using a prospective, uncontrolled before-and-after design, we compared traditional soap-water bathing (pre-intervention period) with CHG bathing over a one-year intervention and one-year post-intervention follow-up. The total number of patients and patient days admitted to the ICU per year were around 1330-1412 patients and 6702-6927 patient days, respectively, during 2018-2020. Results showed a significant reduction in HAI incidence rates from 3.43‱ to 0.58‱ ( < 0.05) during the intervention and sustained benefits post-intervention. Incidences of CAUTI and CLABSI decreased markedly ( < 0.05), with reduced MDRO isolates, including methicillin-resistant , vancomycin-resistant , carbapenem-resistant , and . Our findings support the implementation of daily CHG bathing as an effective strategy to reduce HAI and MDROs in ICU settings.
医疗保健相关感染（HAIs）显著增加了发病率、死亡率、住院时间和成本，在重症监护病房（ICU）患者中尤为如此。尽管采取了标准干预措施，但导尿管相关尿路感染（CAUTI）和中心静脉导管相关血流感染（CLABSI）仍然是主要的HAI促成因素。本研究评估了在一家地区医院的20张床位ICU中，每日使用2%葡萄糖酸氯己定（CHG）沐浴在降低HAI发生率，特别是CAUTI、CLABSI和多重耐药菌（MDROs）方面的效果。采用前瞻性、非对照的前后设计，我们在一年的干预期和一年的干预后随访期内，将传统的肥皂水沐浴（干预前期）与CHG沐浴进行了比较。在2018 - 2020年期间，每年入住ICU的患者总数和患者住院天数分别约为1330 - 1412例患者和6702 - 6927个患者住院日。结果显示，在干预期间HAI发生率从3.43‰显著降低至0.58‰（P < 0.05），且在干预后仍持续受益。CAUTI和CLABSI的发生率显著下降（P < 0.05），MDRO分离株减少，包括耐甲氧西林金黄色葡萄球菌、耐万古霉素肠球菌、耐碳青霉烯类肠杆菌科细菌和鲍曼不动杆菌。我们的研究结果支持将每日CHG沐浴作为一种在ICU环境中降低HAI和MDROs的有效策略加以实施。
