TY  - JOUR
T1  - EFfect of chlorhexidine whole-body bathing on hospital-acquired infections among trauma patients
AU  - Evans HL, Dellit TH, Chan J, Nathens AB, Maier RV, Cuschieri J
Y1  - 2010/03/01
N1  - 10.1001/archsurg.2010.5
JO  - Archives of Surgery
SP  - 240
EP  - 246
VL  - 145
IS  - 3
N2  - Objective 
    To demonstrate whether daily bathing with cloths impregnated with 2% chlorhexidine gluconate will decrease colonization of resistant bacteria and reduce the rates of health care–associated infections in critically injured patients.Design 
    Retrospective analysis of data collected 6 months before and after institution of a chlorhexidine bathing protocol.Setting 
    A 12-bed intensive care unit in a level I trauma center.Patients 
    Two hundred eighty-six severely injured patients underwent daily chlorhexidine bathing during the 6-month intervention; 253 patients were bathed without chlorhexidine prior to the intervention.Interventions 
    Daily chlorhexidine bathing.Main Outcomes Measures 
    Rates of ventilator-associated pneumonia (VAP), bloodstream infection, and colonization with resistant organisms (methicillin-resistant Staphylococcus aureus [MRSA] or Acinetobacter species).Results 
    Baseline patient and injury characteristics were similar between cohorts. Patients receiving chlorhexidine baths were significantly less likely to acquire a catheter-related bloodstream infection than comparators (2.1 vs 8.4 infections per 1000 catheter-days, P = .01). The incidence of VAP was not affected by chlorhexidine baths (16.9 vs 21.6 infections per 1000 ventilator-days in those with vs those without chlorhexidine baths, respectively, P = .30). However, patients who received chlorhexidine baths were less likely to develop MRSA VAP (1.6 vs 5.7 infections per 1000 ventilator-days, P = .03). The rate of colonization with MRSA (23.3 vs 69.3 per 1000 patient-days, P < .001) and Acinetobacter (1.0 vs 4.6 per 1000 patient-days, P = .36) was significantly lower in the chlorhexidine group than in the comparison group.Conclusions 
    Daily bathing of trauma patients with cloths impregnated with 2% chlorhexidine gluconate is associated with a decreased rate of colonization by MRSA and Acinetobacter and lower rates of catheter-related bloodstream infection and MRSA VAP.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2010.5
UR  - http://dx.doi.org/10.1001/archsurg.2010.5
ER  -