Impact of chlorhexidine-impregnated washcloths on reducing incidence of vancomycin-resistant enterococci colonization

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Intravenous literature: Bass, P., Karki, S., Rhodes, D., Gonelli, S., Land, G., Watson, K., Spelman, D., Harrington, G., Kennon, J. and Cheng, A.C. (2013) Impact of chlorhexidine-impregnated washcloths on reducing incidence of vancomycin-resistant enterococci colonization in hematology–oncology patients. AJIC: American Journal of Infection Control. 41(4), p.345-348.

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).

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.

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