Program Schedule

367
Effect of Daily Chlorhexidine (CHG) Bathing on Multidrug-resistant Organisms (MDROs) Transmission and Infection at an Intensive Care Unit (ICU)

Session: Poster Abstract Session: Multidrug-resistant Organisms: Epidemiology and Prevention
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • IDSA2014_Baņos_CHG_Poster.pdf (1.1 MB)
  • Background: Although daily bathing with CHG may prevent the acquisition of Gram positive MDROs (methicillin-resistant S. aureus and vancomycin-resistant enterococcus), scant data exists on the impact of this strategy for Gram negative MDROs (carbapenemase-producing K. pneumoniae, P. aeruginosa, and Acinetobacter spp). The aim of this study was to determine whether daily bathing with CHG decreased MDROs acquisition among adult medical-surgical ICU patients

    Methods: Since Jul-2010 an active surveillance protocol to identify asymptomatic colonization by MDROs at ICU admission or weekly during the patient stay, was implemented. In addition a daily bathing with no-rinse 2% CHG-impregnated washcloths was implemented at the end of 2011, reached 100% compliance from Jan-2012. The MDROs incoming colonization pressure and MDROs acquisition rate were estimated as the number of isolation of MDROs from surveillance or clinical culture performed less than 48 hours after admittance to the ICU per 1,000 admissions and more than 48 hours after admittance to the ICU per 1,000 patient-days, respectively. Through a prospective before and after study both indicators were compared between Period A: Jul-2010/Dec-2011 and Period B: Jan-2012/Dec-2013. In all instances non duplicated cases were considered

    Results: While there was an 135% increase in the incoming colonization pressure during Period B vs Period A for Gram positive MDROs (92.42 cases per 1000 admissions vs 39.30 cases per 1000 admissions; difference 53.12 [95% confidence interval (CI) 1.89 to 8.73]; p<0.01) and a 90% for Gram negative MDROs (33.18 cases per 1000 admissions vs 17.47 cases per 1000 admissions; difference 15.71 [95% CI –5.47 to 36.88]; p<0,15), a significant reduction was observed for the acquisition of Gram positive and Gram negative MDROs (2.40 cases per 1000 patient-days vs 4.86 cases per 1000 patient-days; difference –2.46 [95% CI –0.57 to –4.34]; p<0.01; 3.86 cases per 1000 patient-days vs 7.21 cases per 1000 patient-days; difference –3.36 [95%CI –1.03 to –5.68]; p<0.01, respectively)

    Conclusion: Daily bathing with CHG-impregnated washcloths significantly reduced the risks of acquisition of both Gram positive and negative MDROs, in spite the increase of the incoming colonization pressure rate

    Rodolfo Quiros, MD1, Maria Casanova, MD1, Maria Pereyra Acuņa, MD1, Guillermina Kremer, MD1, Andrea Novau, RN1, Leonardo Fabbro, RN1, Marcelino Enriquez, RN2 and Maximiliana La Rosa Salaberry, RN2, (1)Prevention and Control Infection Department, HOSPITAL UNIVERSITARIO AUSTRAL, PILAR, Argentina, (2)Adult Medical-Surgical Intensive Care Unit, HOSPITAL UNIVERSITARIO AUSTRAL, PILAR, Argentina

    Disclosures:

    R. Quiros, None

    M. Casanova, None

    M. Pereyra Acuņa, None

    G. Kremer, None

    A. Novau, None

    L. Fabbro, None

    M. Enriquez, None

    M. La Rosa Salaberry, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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