Daily bathing with washcloths impregnated with the antiseptic agent chlorhexidine reduced acquisition rates of multidrug-resistant organisms (MDROs) and hospital-acquired bloodstream infections, according to a study in The New England Journal of Medicine (2013;368:533-542).
The nonblinded study enrolled 7,727 patients in nine units in six hospitals. The units included cardiac surgery, coronary care, medical, surgical ICUs and a bone marrow transplantation unit, among others. During the initial six months, units were randomized to perform daily bathing either with washcloths impregnated with 2% chlorhexidine gluconate or with non-antimicrobial washcloths. During the second six-month period, daily bathing with the alternate product occurred.
According to the researchers, the overall rate of MDRO acquisition was 23% lower with chlorhexidine bathing than without; the rate for chlorhexidine was 5.10 cases per 1,000 patient-days compared with 6.60 cases per 1,000 patient-days with non-antimicrobial washcloths (P=0.03). MDROs tracked were methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The overall rate of VRE acquisition was 25% lower with chlorhexidine than with non-antimicrobial bathing (3.21 vs. 4.28 cases per 1,000 patient-days, P=0.05). The overall rate of MRSA acquisition was 19% lower with chlorhexidine than with non-antimicrobial bathing; the difference was not significant (1.89 vs. 2.32 cases per 1,000 patient-days; P=0.29).
The overall rate of hospital-acquired bloodstream infections was 28% lower with chlorhexidine than without (4.78 vs. 6.60 cases per 1,000 patient-days; P=0.007). The rate of primary bloodstream infections was 31% lower for chlorhexidine compared with the control (3.61 vs. 5.24 cases per 1,000 patient-days; P=0.006).