Document Type
Article
Original Publication Date
2013
Journal/Book/Conference Title
The New England Journal of Medicine
Volume
368
DOI of Original Publication
10.1056/NEJMoa1113849
Date of Submission
January 2015
Abstract
BACKGROUND
Results of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs).
METHODS
We conducted a multicenter, cluster-randomized, nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections. Nine intensive care and bone marrow transplantation units in six hospitals were randomly assigned to bathe patients either with no-rinse 2% chlorhexidine– impregnated washcloths or with nonantimicrobial washcloths for a 6-month period, exchanged for the alternate product during the subsequent 6 months. The incidence rates of acquisition of MDROs and the rates of hospital-acquired bloodstream infections were compared between the two periods by means of Poisson regression analysis.
RESULTS
A total of 7727 patients were enrolled during the study. The overall rate of MDRO acquisition was 5.10 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.03), the equivalent of a 23% lower rate with chlorhexidine bathing. The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.007), a 28% lower rate with chlorhexidine-impregnated washcloths. No serious skin reactions were noted during either study period.
CONCLUSIONS
Daily bathing with chlorhexidine-impregnated washcloths significantly reduced the risks of acquisition of MDROs and development of hospital-acquired bloodstream infections. (Funded by the Centers for Disease Control and Prevention and Sage Products; ClinicalTrials.gov number, NCT00502476.)
Rights
From the New England Journal of Medicine, Climo, M. W., Wong, E. S., Sanogo, K. et al., Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection, Vol. 368, Page 533, Copyright © 2013 Massachusetts Medical Society. Reprinted with permission.
Is Part Of
VCU Medical Center Publications
Supplementary Appendix
nejmoa1113849_disclosures.pdf (271 kB)
Disclosure Forms
nejmoa1113849_protocol.pdf (2071 kB)
Comments
Originially Published at http://dx.doi.org/10.1056/NEJMoa1113849
This article was updated on May 23, 2013, at NEJM.org. The correction was published as follows:
Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection (Original Article, N Engl J Med2013 368 533 542) . In the lower portion of Figure 1 (page 538), all the values given for No. at Risk and for Total Cumulative No. of Primary BSIs were incorrect. The figure has been replaced, and the article is correct at NEJM.org.