Source: DGNews  |  Posted 1 year ago

CHICAGO -- March 15, 2010 -- Bathing trauma patients daily using cloths
containing the antiseptic chlorhexidine may be associated with a decreased rate
of colonisation and infection by methicillin-resistant Staphylococcus
aureus (MRSA) and other difficult-to-treat bacteria, according to a study
published in the March issue of Archives of Surgery.

“Healthcare-associated infections pose a significant burden to patients
admitted following major injury,” the authors wrote as background information
in the article. Chlorhexidine gluconate has broad activity against bacteria,
yeasts and viruses and has previously been shown to reduce the acquisition of
MRSA and other resistant organisms.

Heather L. Evans, MD, UW Medicine’s Harborview Medical Center, Seattle,
Washington, and colleagues conducted a study in which 253 patients admitted to
a level 1 trauma centre between November 2006 and April 2007 were bathed at
least once daily using a single-use cloth bath product not known to have
antibacterial or antiseptic properties. For the next 6 months, from May through
October 2007, 286 patients in the same trauma centre received daily baths in
cloths impregnanted with a 2% chlorhexidine solution.

Patients receiving chlorhexidine baths were significantly less likely to
acquire a catheter-related bloodstream infection (2.1 vs 8.4 infections for
every 1,000 days with a vascular catheter in place) or ventilator-associated
pneumonia caused by MRSA (1.6 vs 5.7 infections for every 1,000 days requiring
ventilator support) than those who received baths with the non-medicated cloth.

In addition, the rates of colonisation with MRSA and Acinetobacter
were lower among those in the chlorhexidine group.

“Antibiotic-resistant bacteria pose a unique challenge, and substantial
resources are devoted to infection control to reduce their transmission,” the
authors wrote. “Patients with severe disease, recent surgery and indwelling
devices are at higher risk of colonisation and infection; trauma patients, in
particular, are at risk of MRSA and vancomycin-resistant enterococci.”

“Poor compliance with hand hygiene, reluctance to adopt barrier precautions
owing to unintended consequences of isolation and controversy over the
cost-effectiveness and feasibility of legislated universal surveillance have
been barriers to effective infection control.”

The cloths should not be considered a replacement for hand hygiene or other
precautions, but they may supplement these efforts, the authors noted.

“Our findings support the use of routine chlorhexidine bathing as an adjunctive
infection-control measure to reduce transmission of MRSA, A.
baumannii and potentially other epidemiologically important organisms
that colonise the skin of critically ill hospitalised patients.”

SOURCE: Archives of Surgery