Weekly chlorhexidine douche: does it reduce healthcare-associated bloodstream infections?

• Published in: Scandinavian journal of infectious diseases 2014-10, Vol.46 (10), p.697-703
• Main Authors: Seyman, Derya, Oztoprak, Nefise, Berk, Hande, Kizilates, Filiz, Emek, Mestan
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents, Local - administration & dosage; bloodstream infection; Chlorhexidine - administration & dosage; chlorhexidine shower gel; Cross Infection - epidemiology; Cross Infection - prevention & control; Humans; Incidence; Intensive Care Units; Prevalence; Prospective Studies; Sepsis - epidemiology; Sepsis - prevention & control; Tertiary Care Centers; Therapeutic Irrigation - methods; Weekly douche
• ISSN: 0036-5548; 1651-1980
• DOI: 10.3109/00365548.2014.931597

Abstract Background: Daily chlorhexidine (CHG) bathing has been used as a precaution to reduce the rate of healthcare-associated bloodstream infections (HA-BSI). The application frequency of CHG bathing remains unclear, this procedure has been implemented daily by this time. The aim of this study was to determine the efficacy of weekly whole-body douche with CHG shower gel on rates of HA-BSI. Methods: We conducted a prospective intervention trial in medical, surgical, and anesthesiology intensive care units (ICUs) in a tertiary teaching hospital from June 2011 to November 2012. This study included three periods. During the first period, patients received a daily bed bath by wiping with water and soap. In the second period patients were given a weekly douche with water and soap; in the third period patients were given a weekly douche with CHG shower gel. The rates of HA-BSI were compared between the three periods using Poisson regression analysis. Results: The central line-associated bloodstream infection rates did not decline significantly between periods (p = 0.76). The laboratory-confirmed bloodstream infection (LCBSI) rates in the first, second, and third periods were 7.1, 4, and 1.7, respectively. The LCBSI rates were reduced 43.7% from the first period to the second period (p = 0.03). In addition, there was a 57.5% reduction in LCBSI rates between the second and third periods (p < 0.001). Interestingly, the major decline (76.1%) was determined from the first to the third period (p < 0.002). Conclusions: Weekly douche with CHG shower gel significantly reduced LCBSI rates. Further studies are needed to validate the clinical impact of different intervals of CHG bathing.