Program Schedule

Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) Trial: A subgroup-analysis

Session: Poster Abstract Session: MRSA and VRE
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC

Background : Multiple interventions exist to limit transmission of methicillin-resistant Staphylococcus aureus (MRSA). The effect of combining different interventions is not known.

Methods: We conducted a subgroup analysis of the Benefits of Universal Glove and Gown (BUGG) trial to examine the effect of universal gloving and gowning while using other infection control interventions.

Results: Over 20 ICUs and 26,180 patient admissions, the reduction in MRSA transmission observed in BUGG tended to be greater in units also using chlorhexidine bathing (rate difference -1.20, 95% CI -5.02 to 2.63, p-value=0.18) and was significantly greater in units switching from active surveillance culturing for MRSA (rate difference -8.16, 95% CI -16.42 to 0.01, p-value=0.05). We found universal glove and gown use worked equally well in academic and non-academic ICUs (p=0.15).

Conclusion: The reduction in MRSA observed with the universal glove and gown intervention was persistent in units also using chlorhexidine bathing and in academic and non-academic hospitals. Universal glove and gown use appeared to work as well or better in ICUs adopting universal glove and gown after being on active surveillance culturing.

Figure 1: Frequency of MRSA acquisition in patients during baseline and study periods representing the effect of universal glove and gown on patients in intensive care units that did or did not use chlorhexidine bathing.


Daniel Morgan, MD, MS1,2, Lisa Pineles, MA3, Michelle Shardell, PhD4, Carol Sulis, MD5, Daniel H. Kett, M.D.6, Jason E. Bowling, MD7, Beverly Belton, RN, MSN, NE-BC8, Anthony D. Harris, MD, MPH3 and BUGG Study PIs, (1)VA Maryland HCS, Baltimore, MD, (2)Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, (3)Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, (4)University of Maryland, baltimore, MD, (5)Boston Medical Center, Boston, MA, (6)Division of Pulmonary and Critical Care Medicine, University of Miami/ Jackson Memorial Hospital, Miami, FL, (7)University of Texas Health Science Center at San Antonio, San Antonio, TX, (8)Yale New Haven Health System, New Haven, CT


D. Morgan, None

L. Pineles, None

M. Shardell, None

C. Sulis, None

D. H. Kett, None

J. E. Bowling, None

B. Belton, None

A. D. Harris, None

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