The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: Results of a quasi-experimental multicenter trial*

Climo, Michael W.; Sepkowitz, Kent A.; Zuccotti, Gianna; Fraser, Victoria J.; Warren, David K.; Perl, Trish M.; Speck, Kathleen; Jernigan, John A.; Robles, Jaime R.; Wong, Edward S.

doi:10.1097/ccm.0b013e31819ffe6d

Cited by 288 publications

(202 citation statements)

References 34 publications

Supporting

Mentioning

188

Contrasting

Unclassified

Order By: Relevance

“…Chlorhexidine gluconate has been shown to be effective in reducing the risk of infection compared with standard washes and other antiseptic methods in a variety of medical specialties when applied after invasive procedures [3]. As such, a retrospective study by Farber et al [10] evaluated a total of 3715 patients using a similar chlorhexidine cloth protocol and showed contrasting results.…”

Section: Discussionmentioning

confidence: 99%

“…Those authors used a single application the morning of surgery, whereas our study used two applications, one the morning of and the second the evening before surgery. The potential benefit of the two-part application could have been demonstrated to be the result of a cumulative effect whereby there was a higher bactericidal cutaneous concentration [3]. Additionally, the superior protection against infection could have also been attributed to the rapid and residual bactericidal effects of chlorhexidine [13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Hip Arthroplasty?

Kapadia

Jauregui

Murray

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Periprosthetic hip infections are among the most catastrophic complications after total hip arthroplasty (THA). We had previously proven that the use of chlorhexidine cloths before surgery may help decrease these infections; hence, we increased the size of the previously reported cohort. Questions/purposes (1) Does a preadmission chlorhexidine cloth skin preparation protocol decrease the risk of surgical site infection in patients undergoing THA? (2) When stratified using the National Healthcare Safety Network (NHSN) risk categories, which categories are associated with risk reduction from the preadmission chlorhexidine preparation protocol? Methods Between 2007 and 2013, a group of 998 patients used chlorhexidine cloths before surgery, whereas a group of 2846 patients did not use them and underwent standard perioperative disinfection only. Patient records were reviewed to determine the development of periprosthetic infection in both groups of patients. Results Patients without the preoperative chlorhexidine gluconate disinfection protocol had a higher risk of infections (infections with protocol: six of 995 [0.6%]; infections in control: 46 of 2846 [1.62%]; relative risk: 2.68 [95% confidence interval {CI}, 1.15-0.26]; p = 0.0226). When stratified based on risk category, no differences were detected; preadmission chlorhexidine preparation was not associated with reduced infection risk for low, medium, and high NHSN risk categories (p = 0.386, 0.153, and 0.196, respectively). Conclusions The results of our study suggest that this cloth application appears to reduce the risk of infection in patients undergoing THA. When stratified by risk categories, we found no difference in the infection rate, but these findings were underpowered. Although future multicenter randomized trials will need to confirm these preliminary findings, the intervention is inexpensive and is unlikely to be risky and so might be considered on the basis of this retrospective, comparative study. Level of Evidence Level III, therapeutic study.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Hip Arthroplasty?

Kapadia

Jauregui

Murray

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Many reports have shown that a whole-body bath with an antiseptic agent reduces the bacterial load in the skin and lowers the risk of developing SSI (32)(33)(34)(35). According to the CDC, SSIs are the second most common cause of nosocomial infections and are responsible for more than 25% of hospitalrelated infections in the United States (36,37).…”

Section: Cleansing)mentioning

confidence: 99%

Prevention of Periprosthetic Joint Infection

Rezapoor

Parvızı

2015

The Journal of Arthroplasty

119

View full text Add to dashboard Cite

“…1 In addition to reducing HA-BSI, this strategy has also been shown to significantly reduce the transmission (acquisition) of multi-drug-resistant organisms (MDRO) in the ICU setting. 2,3 By contrast, much less data is available on this issue for patients in the setting of a general ward. One study reports a significant reduction in Clostridium difficile infection with the use of hospital-wide daily CHG baths.…”

Section: Introductionmentioning

confidence: 99%

The effect of daily chlorhexidine baths on nosocomial meticillin-resistant Staphylococcus aureus infection in MRSA-colonized patients admitted to general wards

Willis¹,

Ooi²,

Foo³

et al. 2015

Int. j. infect. control

View full text Add to dashboard Cite

Compared to the Intensive Care Unit setting, relatively little data has been published on the benefits of daily Chlorhexidine gluconate (CHG) baths in infection prevention on general wards. To contribute to our knowledge of this infection prevention strategy we report three years of cumulative data from a 550-bed general hospital in Singapore. Our hospital infection control policy mandates Meticillin-resistant Staphylococcus aureus (MRSA) entry-screening for all cases admitted to hospital. Positive cases are isolated or cohorted with appropriate contact precautions. In addition positive cases receive daily 4% CHG baths throughout their stay. We compare the rates of hospital-acquired MRSA (HA-MRSA) infection in the cohort that screened MRSA-positive (and hence received daily CHG baths) with the cohort in whom MRSA was not detected and hence did not receive CHG baths. Of 4598 screen-positive cases only 4 developed HA-MRSA infection. This compares to 36 cases of HA-MRSA infection among 5391 patients who we estimate were undetected MRSA-carriers, either because they missed screening, or screened false-negative, or acquired MRSA during their hospital stay. MRSA-colonized patients receiving daily CHG baths while in hospital were significantly less likely to develop HA-MRSA infection (OR = 0.129; P = 0.0001; 95% CI 0.046-0.36; NNT = 172). We conclude that General Ward patients who screen MRSA-positive on admission and who receive daily CHG baths throughout hospitalization have a significantly lower rate of HA-MRSA infection compared to patients who screen MRSA-negative and who do not receive such CHG baths.

show abstract

The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: Results of a quasi-experimental multicenter trial*

Cited by 288 publications

References 34 publications

Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Hip Arthroplasty?

Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Hip Arthroplasty?

Prevention of Periprosthetic Joint Infection

The effect of daily chlorhexidine baths on nosocomial meticillin-resistant Staphylococcus aureus infection in MRSA-colonized patients admitted to general wards

Contact Info

Product

Resources

About