Monday June 22, 2009
Gone would be the days of nice smelling shampoo

Recent work by Michael Climo et al. studied the effect of bathing with chlorhexidine on the acquisition of MRSA and VRE, and health care blood stream infections (BSI).

Design: Six ICU at four academic centers. They measured the incidence of MRSA and VRE colonization and BSI during a period of bathing with routine soap for six months and then compared results with a 6 month period with bathing with chlorhexidine solution.

Results: Acquisition of MRSA decreased by 32% (5.04 vs. 3.44 cases/1000 patient days p=0.046), VRE decreased by 50% (4.35 vs. 2.19 cases/1000 patient days p=0.008). VRE-colonized patients bathed with chlorhexidine had a lower risk of developing VRE bacteremia (RR 3.35, 95% CI 1.13-9.87; p=0.035), suggesting that reduction in the level of colonization leads to the observed reductions in BSI


Conclusion: We conclude that daily chlorhexidine bathing among ICU patients may reduce the acquisition of MRSA and VRE. The approach is simple to implement and inexpensive and may be an important adjunctive intervention to barrier precautions to reduce acquisition of VRE and MRSA and the subsequent development of healthcare-associated BSI.



Reference: Click to get abstract

Climo M, Sepkowitz K, Zuccotti G, Victoria F et al. The effect of daily bathing with chlorhexidine on the acquisition of MRSA, VRE and health care-associated bloodstream infections: Result of a quasi-experimental multicenter trial. Critical Care Medicine; 37(6): 1858-1865.