title: Impact of chlorhexidine-impregnated washcloths on reducing incidence of vancomycin-resistant enterococci colonization in hematology-oncology patients.
abstract: BACKGROUND
  Daily skin cleansing with washcloths impregnated with chlorhexidine gluconate (CHG) of patients in intensive care unit is associated with reduction in incidence of vancomycin-resistant Enterococci (VRE) acquisition. This study describes the impact on incidence of VRE colonization after the implementation of daily skin cleansing with 2% CHG-impregnated washcloths in hematology-oncology patients.
  
  
  METHODS
  In this before-and-after study, we compared the incidence rate of VRE colonization during the baseline period (where routine soap-and-water bathing was used) with the intervention period where patients were cleansed with 2% CHG-impregnated washcloths.
  
  
  RESULTS
  Acquisition of VRE decreased from 7.8% in the baseline to 3.8% in the intervention period (relative risk, 0.48, 95% confidence interval [CI], 0.21-1.09; P = .07). The crude relative rate of acquisition during the intervention period compared with the baseline period was 0.53 (95% CI, 0.23-1.23; P = .13). Patients who had been a roommate of a patient subsequently found to have VRE were at a significantly increased risk for acquiring VRE (hazard ratio, 18.8, 95% CI, 5.37-66.15; P < .001). However, patients admitted to the same bed number of previously known VRE-colonized patient were not at increased risk of VRE acquisition (hazard ratio, 0.37, 95% CI, 0.11-1.22; P = .10).
  
  
  CONCLUSIONS
  We did not observe a statistically significant reduction in the rate of VRE colonization in association with the use of 2% CHG-impregnated washcloths among hematology-oncology patients.
authors.affiliation: Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Pauline
authors.initials: P
authors.lastname: Bass
authors.forename: Surendra
authors.initials: S
authors.lastname: Karki
authors.forename: Deborah
authors.initials: D
authors.lastname: Rhodes
authors.forename: Susan
authors.initials: S
authors.lastname: Gonelli
authors.forename: Gillian
authors.initials: G
authors.lastname: Land
authors.forename: Kerrie
authors.initials: K
authors.lastname: Watson
authors.forename: Denis
authors.initials: D
authors.lastname: Spelman
authors.forename: Glenys
authors.initials: G
authors.lastname: Harrington
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kennon
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000517:prevention & control; D002710:Chlorhexidine / Q000494:pharmacology*; D003428:Cross Infection / Q000517:prevention & control*; D004202:Disinfectants / Q000494:pharmacology; D004203:Disinfection / Q000379:methods*; D016983:Enterococcus / Q000187:drug effects*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control*; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000382:microbiology; D020713:Vancomycin Resistance
chemical_list: D004202:Disinfectants; D002710:Chlorhexidine