Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units
Background/Purpose: Vancomycin-resistant Enterococcus (VRE), a multidrug-resistant, difficult-to-treat pathogen of healthcare-associated infections (HAIs), is now endemic at many intensive care units (ICUs). Chlorhexidine (CHG) bathing is a simple and highly effective intervention to decrease VRE ac...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664620304228 |
| _version_ | 1818329336743198720 |
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| author | Kuei-Lien Tien Jann-Tay Wang Wang-Huei Sheng Hui-Ji Lin Pao-Yu Chung Chin-Yuan Tsan Yi-Hsuan Chen Chi-Tai Fang Yee-Chun Chen Shan-Chwen Chang |
| author_facet | Kuei-Lien Tien Jann-Tay Wang Wang-Huei Sheng Hui-Ji Lin Pao-Yu Chung Chin-Yuan Tsan Yi-Hsuan Chen Chi-Tai Fang Yee-Chun Chen Shan-Chwen Chang |
| author_sort | Kuei-Lien Tien |
| collection | DOAJ |
| description | Background/Purpose: Vancomycin-resistant Enterococcus (VRE), a multidrug-resistant, difficult-to-treat pathogen of healthcare-associated infections (HAIs), is now endemic at many intensive care units (ICUs). Chlorhexidine (CHG) bathing is a simple and highly effective intervention to decrease VRE acquisition, but its effect on VRE-HAIs has not been assessed in prospective studies at ICUs. Methods: This is a cluster quasi-experimental controlled study. Under active VRE surveillance and contact isolation of all identified VRE carriers, four ICUs were assigned to provide 2% CHG bathing for all patients on a daily basis (CHG group) during the intervention period, while another four ICUs were assigned to provide standard care without CHG bathing for all patients (standard care group) during the same period. Results: The CHG group (n = 1501) had a 62% lower crude incidence of VRE-HAIs during the intervention period, compared with the baseline period (1.0 vs. 2.6 per thousand patient-days, P = 0.009), while VRE-HAIs incidence did not change in standard care group (n = 3299) (1.1 vs. 0.5 per thousand patient-days, P = 0.139). In multivariable analyses, CHG bathing was independently associated with a 70% lower risk of VRE-HAIs (adjusted odds ratio [OR] 0.3, 95% confidence interval [CI], 0.2 to 0.7, P = 0.006). In contrast, standard care during the same period had no effect on the risk of VRE-HAIs (adjusted OR 1.8, 95% CI: 0.7 to 4.7, P = 0.259). Conclusion: CHG bathing is a highly effective approach to prevent VRE-HAIs at ICUs, in the context of active VRE surveillance with contact isolation. |
| first_indexed | 2024-12-13T12:46:27Z |
| format | Article |
| id | doaj.art-dc91b86685a54a43bbbca6322218c0ae |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-13T12:46:27Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-dc91b86685a54a43bbbca6322218c0ae2022-12-21T23:45:28ZengElsevierJournal of the Formosan Medical Association0929-66462021-03-01120310141021Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care unitsKuei-Lien Tien0Jann-Tay Wang1Wang-Huei Sheng2Hui-Ji Lin3Pao-Yu Chung4Chin-Yuan Tsan5Yi-Hsuan Chen6Chi-Tai Fang7Yee-Chun Chen8Shan-Chwen Chang9Center for Infection Control, National Taiwan University Hospital, Taipei, TaiwanCenter for Infection Control, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanCenter for Infection Control, National Taiwan University Hospital, Taipei, TaiwanDepartment of Nursing, National Taiwan University Hospital, Taipei, TaiwanDepartment of Nursing, National Taiwan University Hospital, Taipei, TaiwanInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Corresponding author. Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan.Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, TaiwanBackground/Purpose: Vancomycin-resistant Enterococcus (VRE), a multidrug-resistant, difficult-to-treat pathogen of healthcare-associated infections (HAIs), is now endemic at many intensive care units (ICUs). Chlorhexidine (CHG) bathing is a simple and highly effective intervention to decrease VRE acquisition, but its effect on VRE-HAIs has not been assessed in prospective studies at ICUs. Methods: This is a cluster quasi-experimental controlled study. Under active VRE surveillance and contact isolation of all identified VRE carriers, four ICUs were assigned to provide 2% CHG bathing for all patients on a daily basis (CHG group) during the intervention period, while another four ICUs were assigned to provide standard care without CHG bathing for all patients (standard care group) during the same period. Results: The CHG group (n = 1501) had a 62% lower crude incidence of VRE-HAIs during the intervention period, compared with the baseline period (1.0 vs. 2.6 per thousand patient-days, P = 0.009), while VRE-HAIs incidence did not change in standard care group (n = 3299) (1.1 vs. 0.5 per thousand patient-days, P = 0.139). In multivariable analyses, CHG bathing was independently associated with a 70% lower risk of VRE-HAIs (adjusted odds ratio [OR] 0.3, 95% confidence interval [CI], 0.2 to 0.7, P = 0.006). In contrast, standard care during the same period had no effect on the risk of VRE-HAIs (adjusted OR 1.8, 95% CI: 0.7 to 4.7, P = 0.259). Conclusion: CHG bathing is a highly effective approach to prevent VRE-HAIs at ICUs, in the context of active VRE surveillance with contact isolation.http://www.sciencedirect.com/science/article/pii/S0929664620304228Vancomycin-resistant enterococciChlorhexidine bathingHealthcare-associated infections |
| spellingShingle | Kuei-Lien Tien Jann-Tay Wang Wang-Huei Sheng Hui-Ji Lin Pao-Yu Chung Chin-Yuan Tsan Yi-Hsuan Chen Chi-Tai Fang Yee-Chun Chen Shan-Chwen Chang Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units Journal of the Formosan Medical Association Vancomycin-resistant enterococci Chlorhexidine bathing Healthcare-associated infections |
| title | Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units |
| title_full | Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units |
| title_fullStr | Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units |
| title_full_unstemmed | Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units |
| title_short | Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units |
| title_sort | chlorhexidine bathing to prevent healthcare associated vancomycin resistant enterococcus infections a cluster quasi experimental controlled study at intensive care units |
| topic | Vancomycin-resistant enterococci Chlorhexidine bathing Healthcare-associated infections |
| url | http://www.sciencedirect.com/science/article/pii/S0929664620304228 |
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