Effectiveness of Chlorhexidine Bathing to Reduce Catheter-Associated Bloodstream Infections in Medical Intensive Care Unit Patients

Bleasdale, Susan C; Trick, William E.; Gonzalez, Ines M.; Lyles, Rosie D.; Hayden, Mary K.; Weinstein, Robert A.

doi:10.1001/archinte.167.19.2073

Cited by 294 publications

(257 citation statements)

References 24 publications

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“…They compared the infection with an historical cohort and found less infections (0.49% versus 2.24%; p\0.001). Various other studies have also reported reductions in cutaneous bacterial colonization and subsequent infection when using 2% chlorhexidine cloths compared with washing with soap and water [1,29,30].…”

Section: Discussionmentioning

confidence: 86%

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

Kapadia

Jauregui

Murray

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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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.

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Section: Discussionmentioning

confidence: 86%

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

Kapadia

Jauregui

Murray

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…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

121

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“…Following these changes, the rate of infections did not change significantly from our historical (January 2007-July 2008) mean of 1-2 per 1000 catheter-days (Teo et al, 2011). Antisepsis protocols have been shown to reduce the risk of infections (Batra et al, 2010;Bleasdale et al, 2007;McCann & Moore, 2010;Sheng et al, 2009). However, emergence of mupirocin resistance has been documented in peritoneal dialysis patients, but is less well studied in haemodialysis patients (Tacconelli et al, 2003).…”

mentioning

confidence: 74%

High prevalence of mupirocin-resistant staphylococci in a dialysis unit where mupirocin and chlorhexidine are routinely used for prevention of catheter-related infections

Teo

Low

Ding

et al. 2011

Journal of Medical Microbiology

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Effectiveness of Chlorhexidine Bathing to Reduce Catheter-Associated Bloodstream Infections in Medical Intensive Care Unit Patients

Cited by 294 publications

References 24 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

High prevalence of mupirocin-resistant staphylococci in a dialysis unit where mupirocin and chlorhexidine are routinely used for prevention of catheter-related infections

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