Effect of daily chlorhexidine bathing on hospital-acquired infection Journal Article


Authors: Climo, M. W.; Yokoe, D. S.; Warren, D. K.; Perl, T. M.; Bolon, M.; Herwaldt, L. A.; Weinstein, R. A.; Sepkowitz, K. A.; Jernigan, J. A.; Sanogo, K.; Wong, E. S.
Article Title: Effect of daily chlorhexidine bathing on hospital-acquired infection
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 blood-stream infections. Copyright © 2013 Massachusetts Medical Society.
Journal Title: New England Journal of Medicine
Volume: 368
Issue: 6
ISSN: 0028-4793
Publisher: Massachusetts Medical Society  
Date Published: 2013-02-07
Start Page: 533
End Page: 542
Language: English
DOI: 10.1056/NEJMoa1113849
PROVIDER: scopus
PUBMED: 23388005
PMCID: PMC5703051
DOI/URL:
Notes: --- - "Export Date: 1 March 2013" - "CODEN: NEJMA" - "Source: Scopus"
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  1. Kent A Sepkowitz
    270 Sepkowitz