The Impact of Chlorhexidine-Based Bathing on Nosocomial Infections

This study has been completed.
Sponsor:
Collaborators:
Weill Medical College of Cornell University
Washington University School of Medicine
Johns Hopkins University
University of Tennessee
Information provided by:
Hunter Holmes Mcguire Veteran Affairs Medical Center
ClinicalTrials.gov Identifier:
NCT00448942
First received: March 15, 2007
Last updated: NA
Last verified: March 2007
History: No changes posted

March 15, 2007
March 15, 2007
November 2004
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No Changes Posted
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The Impact of Chlorhexidine-Based Bathing on Nosocomial Infections
The Impact of the Use of Chlorhexidine-Based Bathing System in the Hospital to Reduce the Incidence of MRSA/VRE Infection or Colonization and Nosocomial Bloodstream Infections (BSI)

The purpose of this study was to determine if the use of daily chlorhexidine bathing would decrease the incidence of MRSA and VRE colonization and healthcare associated Bloodstream Infections (BSI) among Intensive Care Unit (ICU) patients.

Infections due to Staphylococci including MRSA are the predominant nosocomially acquired complication in the intensive care unit. The increasing incidence of MRSA colonization and infection among ICU patients has been attributed to many factors including increased admission of patients already colonized with MRSA to the ICU, poor compliance with handwashing and barrier precautions, delayed identification of MRSA colonized patients, and understaffing. Measures that have proven to limit horizontal transmission between patients and staff and staff to patients include strict attention to barrier precautions and handwashing. Unfortunately both of these strategies require levels of compliance that are often not achieved.

Nosocomial blood stream infections are a leading source of morbidity and mortality among intensive care unit patients. Several modifiable factors have been shown to increase the risk of bloodstream infections. These include lapses in the use of strict sterile technique in the insertion of central venous catheters and improper site preparation. New CDC guidelines on the prevention of catheter related bloodstream infections recommend that the preferential use of chlorhexidine containing skin disinfectants be used for site preparation prior to insertion. The use of chlorhexidine reduces residual skin organisms as well as inhibits their rebound growth and has been demonstrated to reduce catheter-associated bloodstream infections in comparison to other skin disinfectant products such as povidone-iodine.

As a result of guidelines promoting the use of chlorhexidine, a number of intensive care units have implemented quality improvement projects examining the potential role of chlorhexidine based bathing of intensive care unit patients in reducing nosocomial transmission of multiresisitant organisms such as MRSA and vancomycin-resistant enterocooci (VRE). The goal of the currently proposed study is to analyse existing data from participating intensive care units that have adopted the use of chlorhexidine antisepsis to determine the impact of chlorhexidine on bacterial colonization and nosocomial infections Participating hospitals who have completed quality improvement projects that included the use of chlorhexidine in bathing of ICU patients will submit de-identified data on nosocomial bacteremias and MRSA and VRE colonization during defined time periods where chlorhexidine bathing was used in comparison to time periods where regular bathing procedures were utilized.

Observational
Observational Model: Defined Population
Time Perspective: Longitudinal
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  • Nosocomial Bacteremia
  • Nosocomial Fungemia
  • MRSA Colonization
  • MRSA Infection
  • VRE Colonization
  • VRE Infection
Behavioral: Daily bathing with Chlorhexidine based product
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
5300
January 2006
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Inclusion Criteria:

  • All adult patients admitted to study units

Exclusion Criteria:

  • Children under the age of 18
  • Previous adverse reaction or documented allergy to chlorhexidine based products
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00448942
01115, UR8/CCU315346-03-1
No
Not Provided
Hunter Holmes Mcguire Veteran Affairs Medical Center
  • Weill Medical College of Cornell University
  • Washington University School of Medicine
  • Johns Hopkins University
  • University of Tennessee
  • Centers for Disease Control and Prevention
Principal Investigator: Edward W Wong, MD Hunter Holmes Mcguire Veteran Affairs Medical Center
Hunter Holmes Mcguire Veteran Affairs Medical Center
March 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP