1965. Daily chlorhexidine gluconate bathing for medical inpatients: Reducing the incidence of hospital-associated MRSA and VRE
Session: Oral Abstract Session: Controlling Resistant Gram Positive Infections
Saturday, October 10, 2015: 3:30 PM
Room: 5--AB
Background: Chlorhexidine gluconate (CHG) is an antiseptic with activity against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). The use of CHG for patient bathing has been shown to be effective in decreasing nosocomial infections in the ICU. Limited evidence exists for CHG bathing on non-ICU wards, where there are significant differences in patient population and nursing workload.

Methods: A 6-month prospective study (June 2 – December 2, 2014) on 4 medical inpatient wards at an urban, academic hospital in Vancouver, Canada, was conducted to assess the effectiveness of daily CHG bathing on nosocomial rates of MRSA and VRE. Nosocomial Clostridium difficile (CDI) was also measured as a ‘control’, as CHG does not have sporicidal activity. Two wards served as the control cohort (using soap/water for bathing), while 2 wards used CHG cloths. Nosocomial MRSA, VRE and CDI cases were defined as patients with positive laboratory findings >3 days after admission, or ≤3 days for patients previously admitted to our hospital in the past 4 weeks. Compliance for wards using CHG cloths was monitored weekly. Average bathing time was based on self-reporting by nursing staff on all 4 wards for soap/water at baseline and for the 2 wards using CHG cloths.

Results: Overall, nosocomial rates for MRSA, VRE and CDI were as follows: 33.5, 17.4 and 2.48 per 10,000 inpatient days. A significant reduction in the total number of nosocomial cases between the control and study cohorts for MRSA (15.9 vs. 4.5, p=0.016) and VRE (30.7 vs. 15.6, p=0.036) was observed, but not for CDI (2.3 vs. 6.7, p=0.167). Bathing time for nursing staff was 26 minutes (n=34) with soap and water vs. 6 minutes (n=32) with CHG. Overall compliance with CHG on the study unit was 62%.

Conclusion: Despite suboptimal compliance, reduced rates of nosocomial MRSA and VRE were observed in the 2 medical wards that used daily CHG bathing. In addition, use of CHG may help alleviate nursing workload as it decreased bathing time by an average of 20 minutes. Preliminary results suggest that daily CHG bathing outside of the ICU is effective in preventing nosocomial MRSA and VRE.

Christopher F. Lowe, MD, FRCPC1,2,3, Elisa Lloyd-Smith, PhD1, Baljinder Sidhu, RN, CIC1, Azra Sharma, MLT, MSc1, Danielle Richards, RN, MA1, Thomas Kind, RN1, Victor Leung, MD, FRCPC1,2,3,4 and Marc G. Romney, MD, FRCPC, DTM&H1,2,3, (1)Infection Prevention and Control, Providence Health Care, Vancouver, BC, Canada, (2)Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, (3)Pathology and Laboratory Medicine, Providence Health Care, Vancouver, BC, Canada, (4)Infectious Diseases, University of British Columbia, Vancouver, BC, Canada

Disclosures:

C. F. Lowe, Sage Products: Investigator , Research support

E. Lloyd-Smith, Sage Products: Investigator , Research support

B. Sidhu, None

A. Sharma, None

D. Richards, None

T. Kind, None

V. Leung, None

M. G. Romney, Sage Products: Investigator , Research support

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