title: Weekly chlorhexidine douche: does it reduce healthcare-associated bloodstream infections?
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.
authors.affiliation: Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology.
authors.forename: Derya
authors.initials: D
authors.lastname: Seyman
authors.forename: Nefise
authors.initials: N
authors.lastname: Oztoprak
authors.forename: Hande
authors.initials: H
authors.lastname: Berk
authors.forename: Filiz
authors.initials: F
authors.lastname: Kizilates
authors.forename: Mestan
authors.initials: M
authors.lastname: Emek
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D015995:Prevalence; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control*; D062606:Tertiary Care Centers; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine
keywords: Weekly douche; bloodstream infection; chlorhexidine shower gel