Daily bathing strategies and cross-transmission of multidrug-resistant organisms: Impact of chlorhexidine-impregnated wipes in a multidrug-resistant gram-negative bacteria endemic intensive care unit

Autores de IIS La Fe

• Jesús Ruiz Ramos

  Autor

• Paula Ramírez Galleymore

  Autor

• Esther Villarreal Tello

  Autor

• Mónica Gordón Sahuquillo

  Autor

• Inmaculada Saez Esteve

  Autor

• Alfonso Rodriguez Perea

  Autor

• Patria Castañeda Gordillo

  Autor

• Álvaro Castellanos Ortega

  Autor

Grupos

• Infecciones Respiratorias

  Investigador Principal

  Raúl Méndez Ocaña

• Medicina Intensiva

  Leader

  Álvaro Castellanos Ortega

Abstract

Background: Health-care associated infections are a major cause of morbidity and mortality in critical care units. The aim of this study is to evaluate the effectiveness of chlorhexidine gluconate (CHG)-impregnated wipes in the daily bathing of patients in an intensive care unit (ICU) to prevent cross-transmission and colonization by multidrug-resistant organisms (MDROs) Methods: Prospective cohort study with an intervention of 11 months. The intervention consisted of using CHG-impregnated wipes for the daily bathing of patients on mechanical ventilation or colonized by MDROs. Monthly trends in the number of patients colonized by MDROs and the incidence of nosocomial infections were evaluated. Results: A total of 1,675 patients were admitted to the unit during the intervention period, and 430 (25.7%) were bathed with chlorhexidine wipes. A significant decrease was observed in the incidence of colonization by MDROs over the months (beta = -0.209; r(2) = 0.549; P = .027), and in the number of patients colonized compared with the equivalent period of the previous year (22.0% vs 18.4%; P = .01). No significant decrease was observed in the incidence of nosocomial infection between the two periods (4.11% vs 4.57%; P = .355). No dermatologic problems were observed in the treated patients. Conclusions: The use of CHG-impregnated wipes reduces cross-transmission and colonization by MDROs in the ICUs in an endemic situation because of multidrug-resistant Enterobacteriaceae. (C) 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Keywords

• Chlorhexidine; Nosocomial infection; Intensive care unit; Gram-negative bacteria