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Skin decontamination in critically ill patients. Comparison of two daily bathing methods: traditional bath versus 2% chlorexidine gluconate (CHG) cloths
Antimicrobial Resistance and Infection Control volume 4, Article number: P239 (2015)
Healthcare Associated Infections (HAI) in Intensive Care Units (ICU) settings are still a challenge; skin decontamination is a recommended intervention to interrupt pathogen transmission through “source control”1. Various studies1,2,3,4 investigated the effectiveness of 2 % CHG cloths compared with the use of traditional bathing (soap and water) or pre - impregnated cloths with soap solution (no antiseptic) for the reduction of MDROs acquisitions and blood-stream infections in Intensive Care Unit settings.
The system used for daily patient hygiene at the General Intensive Care Unit (ICU) of the Rimini hospital until April 2013 consisted of a “traditional” method (water and soap). Since May 2013, 2 % CHG cloths (Sage Products LLC) were introduced for the daily bathing of colonized/infected patients (targeted decolonization)3. Afterwards, since October 2013, a new procedure was introduced to extend daily bathing with 2 % CHG cloths to all patients in the ICU (universal decolonization)3. Patients between periods had similar characteristics.
Results compare two periods in which data were collected and analyzed: Period A - November 2012 / April 2013 - 6 months of daily hygienewith soap and water - Pre - intervention.
Period B - October 2013 / July 2014 - 10 months of daily hygiene with 2 % CHG cloths (universal decolonization) Intervention. Number of patients Colonized/Infected: decreased by 51.21% (p - value = 0.00141). Positive blood cultures decreased by 68.32 % (p - value = 0.01699) Return on investment(ROI): estimated decrease of 50% of the total costs, intervention period vs. pre-intervention period.
Daily bathing with 2% CHG cloths significantly reduces the number of patients colonized/infected and MDRO acquisitions. The results and the estimated ROI obtained at the General Intensive Care Unit(ICU) of the Rimini hospital, confirm the opportunity of implementing a universal decolonization protocol in ICU settings.
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Tura, G., Marcatelli, N. & Leardini, P. Skin decontamination in critically ill patients. Comparison of two daily bathing methods: traditional bath versus 2% chlorexidine gluconate (CHG) cloths. Antimicrob Resist Infect Control 4, P239 (2015). https://doi.org/10.1186/2047-2994-4-S1-P239
- Intensive Care Unit
- Positive Blood Culture
- Soap Solution
- Pathogen Transmission
- Healthcare Associate Infection