Chlorhexidine bathing of the critically ill for the prevention of hospital-acquired infection

Lewis, Sharon R; Schofield‐Robinson, Oliver J; Rhodes, Sarah; Smith, Andrew F

doi:10.1002/14651858.cd012248.pub2

Cited by 24 publications

(19 citation statements)

References 53 publications

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“…Since July 1, 2016, we implemented strengthened measures based on previous measures according to the actual conditions of the hospital and introduced the CHG bathing in ICU. Although it was not clear whether bathing with chlorhexidine could reduce hospital-acquired infections, 18 our study showed that the application of bathing with 2% CHG wipes reduced CRAB and CRPA infection in the ICU by 1.56 and 2.15 cases/1000 patient days, respectively, similar to the studies before. 13,19 However, Ruiz et al 13 only performed bath for patients who used mechanical ventilation and those who colonized with MDROs, and Chung et al 19 only evaluated the effect on CRAB.…”

Section: Discussionsupporting

confidence: 87%

Effect of daily chlorhexidine bathing on reducing infections caused by multidrug‐resistant organisms in intensive care unit patients: A semiexperimental study with parallel controls

Huang

Qiao

Cai

et al. 2023

J Evidence Based Medicine

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Background: A number of studies have shown that daily bathing by chlorhexidine (CHG) wipes in ICU can reduce healthcare-associated infections (HAIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). However, the impact of CHG bathing on carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Enterobacteriaceae (CRE) is not clear and remains controversial.Methods: A semi-experimental study which employs both pre-controls and a parallel control was conducted. In the intervention period (from July 1 to December 31, 2016), strengthened infection control measures and daily bathing with 2% CHG-impregnated wipes once daily was performed in the ICU. Fiftyseven non-ICU wards with the occurrence of multidrug-resistant organisms (MDRO) infections during the same time period were selected as parallel control group (only CHG bathing was not performed). The net effect of the 2% CHG daily bathing was evaluated by the difference in difference (DID) model.Results: The incidence of HAIs caused by CRPA in ICU was signi cantly decreased between the intervention and pre-intervention period (2.5, 95% con dence interval (CI) 1. cases /1,000 patient days, P = 0.02). Similarly, the incidence of HAIs caused by CRAB in intervention group was 19.75% lower than that in pre-intervention group (6.0, 95% CI 4.4-7.6 vs. 7.5, 95% CI 5.7-9.3 cases / 1,000 patient days, P = 0.24). The DID model analysis showed that CHG bathing reduced the incidence of CRAB-and CRPA-caused infections in ICU by 1.56 and 2.15 cases/1,000 patient days, respectively, P <0.01, and bathing of every 38 patients (95% CI, 21-268) and 39 patients (95% CI, 24-110) were able to prevent one case of HAIs of CRAB and CRPA, respectively. However, CHG bathing showed no effect on MRSA, VRE and CRE (P>0.05).Conclusion: Daily bathing with 2% CHG-impregnated wipes can reduce HAIs caused by CRAB and CRPA, while it is not effective for the prevalence of infections caused by MRSA, VRE, and CRE.

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Section: Discussionsupporting

confidence: 87%

Effect of daily chlorhexidine bathing on reducing infections caused by multidrug‐resistant organisms in intensive care unit patients: A semiexperimental study with parallel controls

Huang

Qiao

Cai

et al. 2023

J Evidence Based Medicine

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“…Other studies have also shown that chlorhexidine alone or in combination with other antibiotics can prevent and reduce hospital-acquired infections, including respiratory catheter, gastric tube and urinary catheter [ 13 , 19 – 21 ]. For example, Jamal et al [ 21 ] showed chlorhexidine alone, or combine with minocycline and rifampicin, reduced the incidence of A. baumannii catheter-related infections.…”

Section: Discussionmentioning

confidence: 99%

Combination inhibition activity of chlorhexidine and antibiotics on multidrug-resistant Acinetobacter baumannii in vitro

Lin

Wang

et al. 2021

BMC Infect Dis

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Background Chlorhexidine is a widely used disinfectant in clinical settings and a broad-spectrum antimicrobial agent effective against aerobic and anaerobic bacteria. However, disinfectant resistant or non-susceptible bacteria, including antibiotic-resistant Acinetobacter baumannii, have been found. This study aimed to develop a new technique to prevent and control A. baumannii infection in the hospital setting. Methods Chlorhexidine combined with minocycline, doxycycline, meropenem, imipenem, levofloxacin and ciprofloxacin were tested against the 30 multidrug-resistant and extremely drug-resistant A. baumannii clinical isolates. The checkerboard test was used to calculate the fractional inhibitory concentration index according to the minimum inhibitory concentration value for chlorhexidine combined with antibiotics. Results The combination of chlorhexidine with minocycline, doxycycline, meropenem, or ciprofloxacin showed synergistic responses in all clinical isolates, and more than 50% of isolates showed FICI ≤0.5. However, chlorhexidine together with imipenem or levofloxacin showed indifferent responses in 10% and 3.33% clinical isolates, respectively. In all tests, combinations of chlorhexidine with each of the above six antibiotics showed synergistic and additive effects, and inhibited the clinical isolates. Conclusions We concluded that, chlorhexidine combined with antibiotics could be used to control the risk of infection with A. baumannii.

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“…Other studies have also shown that chlorhexidine alone or in combination with other antibiotics can prevent and reduce hospital-acquired infections, including respiratory catheter, gastric tube and urinary catheter [13,[19][20][21]. For example, Jamal et al [21] showed chlorhexidine alone, or combine with minocycline and rifampicin, reduced the incidence of A. baumannii catheter-related infections.…”

Section: Discussionmentioning

confidence: 99%

Combination Inhibition Activity of Chlorhexidine and Antibiotics on Multidrug-Resistant Acinetobacter Baumannii in Vitro

Lin

Wang

et al. 2021

Preprint

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Background: Chlorhexidine is a widely used disinfectant in clinical settings and a broad-spectrum antimicrobial agent effective against aerobic and anaerobic bacteria. However, disinfectant resistant or non-susceptible bacteria, including antibiotic-resistant Acinetobacter baumannii, have been found. This study aimed to develop a new technique to prevent and control A. baumannii infection in the hospital setting. Methods: Chlorhexidine combined with minocycline, doxycycline, meropenem, imipenem, levofloxacin and ciprofloxacin were tested against the 30 multidrug-resistant and extremely drug-resistant A. baumannii clinical isolates. The checkerboard test was used to calculate the fractional inhibitory concentration index according to the minimum inhibitory concentration value for chlorhexidine combined with antibiotics. Results: The combination of chlorhexidine with minocycline, doxycycline, meropenem, or ciprofloxacin showed synergistic responses in all clinical isolates, and more than 50% of isolates showed FICI ≤ 0.5. However, chlorhexidine together with imipenem or levofloxacin showed indifferent responses in 10% and 3.33% clinical isolates, respectively. In all tests, combinations of chlorhexidine with each of the above six antibiotics showed synergistic and additive effects, and inhibited the clinical isolates.Conclusions: We concluded that, chlorhexidine combined with antibiotics could be used to control the risk of infection with A. baumannii.

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Chlorhexidine bathing of the critically ill for the prevention of hospital-acquired infection

Cited by 24 publications

References 53 publications

Effect of daily chlorhexidine bathing on reducing infections caused by multidrug‐resistant organisms in intensive care unit patients: A semiexperimental study with parallel controls

Effect of daily chlorhexidine bathing on reducing infections caused by multidrug‐resistant organisms in intensive care unit patients: A semiexperimental study with parallel controls

Combination inhibition activity of chlorhexidine and antibiotics on multidrug-resistant Acinetobacter baumannii in vitro

Combination Inhibition Activity of Chlorhexidine and Antibiotics on Multidrug-Resistant Acinetobacter Baumannii in Vitro

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