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- Title
Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study.
- Authors
Suh, Jin Woong; Kim, Nam Hee; Lee, Min Jung; Lee, Seoung Eun; Chun, Byung Chul; Lee, Chang Kyu; Lee, Juneyoung; Kim, Jong Hun; Kim, Sun Bean; Yoon, Young Kyung; Sohn, Jang Wook; Kim, Min Ja
- Abstract
Background: Critically ill patients in intensive care units (ICUs) often acquire opportunistic infections or are colonized by vancomycin-resistant enterococci (VRE), which limits therapeutic options and results in high case-fatality rates. In clinical practice, the beneficial effects of universal chlorhexidine gluconate (CHG) bathing on the control of VRE remain unclear. This study aimed to investigate whether 2% CHG daily bathing reduced the acquisition of VRE in the setting of a medical ICU (MICU) with VRE endemicity. Methods: This quasi-experimental intervention study was conducted in a 23-bed MICU of a tertiary care hospital in Korea from September 2016 to December 2017. In a prospective, interrupted time-series analysis (ITS) with a 6-month CHG bathing intervention, we compared the acquisition and incidence of VRE and the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Acinetobacter baumannii (CRAB) between the pre-intervention and intervention periods. The primary and secondary outcomes were a change in the acquisition of VRE and incidence of VRE, MRSA, or CRAB between the two periods, respectively. Results: All the adult patients admitted to the MICU were enrolled in the pre-intervention (n = 259) and intervention (n = 242). The overall CHG daily bathing compliance rate was 72.5%. In the ITS, there was a significant intervention effect with a 58% decrease in VRE acquisition (95% CI 7.1–82.1%, p = 0.038) following the intervention. However, there was no significant intervention effects on the incidence trend of VRE, MRSA, and CRAB determined by clinical culture between the pre-intervention and intervention periods. Conclusion: In this real-world study, we concluded that daily bathing with CHG may be an effective measure to reduce VRE cross-transmission among patients in MICU with a high VRE endemicity.
- Subjects
SOUTH Korea; INTENSIVE care units; ENTEROCOCCUS; MEDICAL care; CARBAPENEM-resistant bacteria; CHLORHEXIDINE
- Publication
Antimicrobial Resistance & Infection Control, 2021, Vol 10, Issue 1, p1
- ISSN
2047-2994
- Publication type
Article
- DOI
10.1186/s13756-021-01030-6