The Impact of Chlorhexidine-Based Bathing on Nosocomial Infections

NCT ID: NCT00448942

Last Updated: 2007-03-19

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 5300 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2004-11-30
• Study Completion Date: 2006-01-31

Brief Summary

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.

Detailed Description

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.

Conditions

Nosocomial Bacteremia; Nosocomial Fungemia; MRSA Colonization; MRSA Infection; VRE Colonization; VRE Infection

Study Design

• Observational Model Type: DEFINED_POPULATION
• Study Time Perspective: RETROSPECTIVE

Interventions

Daily bathing with Chlorhexidine based product

Intervention Type: BEHAVIORAL

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Weill Medical College of Cornell University

OTHER

Sponsor Role: collaborator

Washington University School of Medicine

OTHER

Sponsor Role: collaborator

Johns Hopkins University

OTHER

Sponsor Role: collaborator

University of Tennessee

OTHER

Sponsor Role: collaborator

Centers for Disease Control and Prevention

FED

Sponsor Role: collaborator

Hunter Holmes Mcguire Veteran Affairs Medical Center

FED

Sponsor Role: lead

Principal Investigators

Edward W Wong, MD

Role: PRINCIPAL_INVESTIGATOR

Hunter Holmes Mcguire Veteran Affairs Medical Center

Locations

Johns Hopkins Hospital

Baltimore, Maryland, United States

Barnes Jewish Hospital

St Louis, Missouri, United States

Memorial Sloan-Kettering Cancer Center

New York, New York, United States

Hunter Holmes McGuire Veteran Affairs Medical Center

Richmond, Virginia, United States

Countries

United States

Other Identifiers

UR8/CCU315346-03-1

Identifier Type: -

Identifier Source: secondary_id

01115

Identifier Type: -

Identifier Source: org_study_id