title: Impact of chlorhexidine bathing on hospital-acquired infections among general medical patients.
abstract: BACKGROUND
  A paucity of data exists regarding the effectiveness of daily chlorhexidine gluconate (CHG) bathing in non-intensive care unit (ICU) settings.
  
  
  OBJECTIVE
  To evaluate the effectiveness of daily CHG bathing in a non-ICU setting to reduce methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enteroccocus (VRE) hospital-acquired infections (HAIs), compared with daily bathing with soap and water.
  
  
  METHODS
  Quasi-experimental study design; the primary outcome was the composite incidence of MRSA and VRE HAIs. Clostridium difficile HAI incidence was measured as a nonequivalent dependent variable with which to assess potential confounders.
  
  
  METHODS
  Four general medicine units, with a total of 94 beds, at a 719-bed academic tertiary-care facility in Providence, Rhode Island.
  
  
  METHODS
  A total of 7,102 and 7,699 adult patients were admitted to the medical service in the control and intervention groups, respectively. Patients admitted from January 1 through December 31, 2008, were bathed daily with soap and water (control group), and those admitted from February 1, 2009, through March 31, 2010, were bathed daily with CHG-impregnated cloths (intervention group).
  
  
  RESULTS
  Daily bathing with CHG was associated with a 64% reduced risk of developing the primary outcome, namely, the composite incidence of MRSA and VRE HAIs (hazard ratio, 0.36 [95% CI, 0.2-0.8]; P = .01). There was no change in the incidence of C. difficile HAIs (P = .6). Colonization with MRSA was associated with an increased risk of developing a MRSA HAI (hazard ratio, 8 [95% CI, 3-19]; P < .001).
  
  
  CONCLUSIONS
  Daily CHG bathing was associated with a reduced HAI risk, using a composite endpoint of MRSA and VRE HAIs, in a general medical inpatient population.
authors: Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
authors: Steven Z
authors: SZ
authors: Kassakian
authors: Leonard A
authors: LA
authors: Mermel
authors: Julie A
authors: JA
authors: Jefferson
authors: Stephen L
authors: SL
authors: Parenteau
authors: Jason T
authors: JT
authors: Machan
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001494:Baths; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000453:epidemiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods*; D016983:Enterococcus; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D020713:Vancomycin Resistance
chemical_list: D000891:Anti-Infective Agents, Local; C010882:chlorhexidine gluconate; D002710:Chlorhexidine