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15 results

  • Differential Effects of Chlorhexidine Skin Cleansing Methods on Residual Chlorhexidine Skin Concentrations and Bacterial Recovery

  • Yoona Rhee, Louisa J. Palmer, Koh Okamoto, Sean Gemunden, Khaled Hammouda, Sarah K. Kemble, Michael Y. Lin, Karen Lolans, Louis Fogg, Derek Guanaga, Deborah S. Yokoe, Robert A. Weinstein, Gyorgy Frendl, Mary K. Hayden, for the Centers for Disease Control and Prevention Epicenter Program
  • Journal: Infection Control & Hospital Epidemiology / Volume 39 / Issue 4 / April 2018
  • Published online by Cambridge University Press: 01 March 2018, pp. 405-411
  • Print publication: April 2018
  • BACKGROUND

    Bathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)–impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results.

    OBJECTIVE

    To determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin.

    DESIGN

    Prospective, randomized 2-center study with blinded assessment.

    PARTICIPANTS AND SETTING

    Healthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016.

    INTERVENTION

    Cleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non–antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C).

    RESULTS

    In total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001).

    CONCLUSION

    In healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined.

    Infect Control Hosp Epidemiol 2018;39:405–411