title: Effect of daily chlorhexidine bathing on the acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit with methicillin-resistant S aureus endemicity.
abstract: Universal decolonization is recommended in intensive care units (ICUs) that have unacceptably high rates of methicillin-resistant Staphylococcus aureus (MRSA) despite implementation of basic prevention strategies.
  
  
  
  An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of MRSA in a medical ICU with MRSA endemicity. There was a 14-month control period and a 16-month chlorhexidine bathing period. Segmented Poisson regression analysis was performed to assess the impact of daily chlorhexidine bathing on the incidence density of MRSA. Also, chlorhexidine susceptibility testing with polymerase chain reaction for the qacA/B gene was performed on MRSA isolates collected during the chlorhexidine bathing period.
  
  
  
  There was a significant reduction in trend (-0.056; 95% confidence interval, -0.095 to -0.017; P = .005) of incidence density of MRSA despite a significant increase in both level and trend of MRSA prevalence rates during the chlorhexidine bathing period. However, there was no significant reduction in level of incidence density of MRSA during the interventional period. Minimum inhibitory concentration of chlorhexidine and the detection rates of the qacA/B gene for a total of 174 MRSA isolates did not increase during the chlorhexidine bathing period.
  
  
  
  Daily chlorhexidine bathing resulted in a significantly decreasing trend of MRSA acquisition rates irrespective of increased MRSA prevalence rates in the medical ICU. There was no shift of chlorhexidine-resistant MRSA strains.
authors: Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
authors: Jae-Seok
authors: JS
authors: Kim
authors: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
authors: Yun Kyung
authors: YK
authors: Chung
authors: Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. Electronic address: hushh93@hallym.or.kr.
authors: Seung Soon
authors: SS
authors: Lee
authors: Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
authors: Jeong-A
authors: JA
authors: Lee
authors: Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
authors: Han-Sung
authors: HS
authors: Kim
authors: Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
authors: Eun Young
authors: EY
authors: Park
authors: Department of Occupational and Environmental Medicine, Seegene Medical Foundation, Seoul, Republic of Korea.
authors: Kyong-Sok
authors: KS
authors: Shin
authors: Medical Intensive Care Unit, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors: Bog Soun
authors: BS
authors: Kang
authors: Medical Intensive Care Unit, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors: Hee Jung
authors: HJ
authors: Lee
authors: Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors: Hyun Joo
authors: HJ
authors: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000494:pharmacology; D001494:Baths; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage* / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D065186:Interrupted Time Series Analysis; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine
keywords: Chlorhexidine gluconate; baths; intensive care units; methicillin-resistant Staphylococcus aureus