Impact of chlorhexidine-impregnated washcloths on reducing incidence of vancomycin-resistant enterococci colonization in hematology–oncology patients

• Published in: American journal of infection control Vol. 41; no. 4; pp. 345 - 348
• Main Authors: Bass, Pauline, RN, BSc, Karki, Surendra, MSc, MIH, DipVac, Rhodes, Deborah, RN, Gonelli, Susan, RN, Land, Gillian, RN, Watson, Kerrie, MSc, Spelman, Denis, MBBS, MPH, FRACP, FRACPA, Harrington, Glenys, RN, Kennon, Jacqueline, RN, GradDip (Clin Epi), Cheng, Allen C., PhD, MBBS, MPH, FRACP
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-04-2013; Elsevier; Mosby-Year Book, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiseptics; Bacteria; Biological and medical sciences; Carrier State - prevention & control; Chlorhexidine; Chlorhexidine - pharmacology; Colonization; Cross Infection - prevention & control; Disinfectants - pharmacology; Disinfection - methods; Drug resistance; Enterococcus - drug effects; Epidemiology. Vaccinations; Female; General aspects; Gram-Positive Bacterial Infections - prevention & control; Hematologic Neoplasms - complications; Hematology; Humans; Incidence; Infection Control; Infectious Disease; Infectious diseases; Intervention; Male; Medical sciences; Middle Aged; Oncology; Pharmacology. Drug treatments; Skin - microbiology; Skin care products; Vancomycin Resistance; VRE; Australia; VRE; Chlorhexidine; Colonization; Incidence; Enterococcus; Human; Hematology; Check; Guanidines; Epidemiology; Prevention; Infection; Streptococcaceae; Biguanides; Antiseptic; Bacteria; Micrococcales; Disinfecting agent
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2012.04.324

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). Conclusion 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.