Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study

Abstract Background Critically ill patients in intensive care units (ICUs) often acquire opportunistic infections or are colonized by vancomycin-resistant enterococci (VRE), which limits therapeutic options and results in high case-fatality rates. In clinical practice, the beneficial effects of univ...

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Autores principales:	Jin Woong Suh, Nam Hee Kim, Min Jung Lee, Seoung Eun Lee, Byung Chul Chun, Chang Kyu Lee, Juneyoung Lee, Jong Hun Kim, Sun Bean Kim, Young Kyung Yoon, Jang Wook Sohn, Min Ja Kim
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Chlorhexidine gluconate Baths Vancomycin-resistant enterococci Acquisition Intensive care unit Interrupted time-series analysis Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/03cf2bc02ea84ee28758dae26572504f
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spelling	oai:doaj.org-article:03cf2bc02ea84ee28758dae26572504f2021-11-14T12:38:25ZReal-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study10.1186/s13756-021-01030-62047-2994https://doaj.org/article/03cf2bc02ea84ee28758dae26572504f2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13756-021-01030-6https://doaj.org/toc/2047-2994Abstract Background Critically ill patients in intensive care units (ICUs) often acquire opportunistic infections or are colonized by vancomycin-resistant enterococci (VRE), which limits therapeutic options and results in high case-fatality rates. In clinical practice, the beneficial effects of universal chlorhexidine gluconate (CHG) bathing on the control of VRE remain unclear. This study aimed to investigate whether 2% CHG daily bathing reduced the acquisition of VRE in the setting of a medical ICU (MICU) with VRE endemicity. Methods This quasi-experimental intervention study was conducted in a 23-bed MICU of a tertiary care hospital in Korea from September 2016 to December 2017. In a prospective, interrupted time-series analysis (ITS) with a 6-month CHG bathing intervention, we compared the acquisition and incidence of VRE and the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Acinetobacter baumannii (CRAB) between the pre-intervention and intervention periods. The primary and secondary outcomes were a change in the acquisition of VRE and incidence of VRE, MRSA, or CRAB between the two periods, respectively. Results All the adult patients admitted to the MICU were enrolled in the pre-intervention (n = 259) and intervention (n = 242). The overall CHG daily bathing compliance rate was 72.5%. In the ITS, there was a significant intervention effect with a 58% decrease in VRE acquisition (95% CI 7.1–82.1%, p = 0.038) following the intervention. However, there was no significant intervention effects on the incidence trend of VRE, MRSA, and CRAB determined by clinical culture between the pre-intervention and intervention periods. Conclusion In this real-world study, we concluded that daily bathing with CHG may be an effective measure to reduce VRE cross-transmission among patients in MICU with a high VRE endemicity.Jin Woong SuhNam Hee KimMin Jung LeeSeoung Eun LeeByung Chul ChunChang Kyu LeeJuneyoung LeeJong Hun KimSun Bean KimYoung Kyung YoonJang Wook SohnMin Ja KimBMCarticleChlorhexidine gluconateBathsVancomycin-resistant enterococciAcquisitionIntensive care unitInterrupted time-series analysisInfectious and parasitic diseasesRC109-216ENAntimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Chlorhexidine gluconate Baths Vancomycin-resistant enterococci Acquisition Intensive care unit Interrupted time-series analysis Infectious and parasitic diseases RC109-216
spellingShingle	Chlorhexidine gluconate Baths Vancomycin-resistant enterococci Acquisition Intensive care unit Interrupted time-series analysis Infectious and parasitic diseases RC109-216 Jin Woong Suh Nam Hee Kim Min Jung Lee Seoung Eun Lee Byung Chul Chun Chang Kyu Lee Juneyoung Lee Jong Hun Kim Sun Bean Kim Young Kyung Yoon Jang Wook Sohn Min Ja Kim Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study
description	Abstract Background Critically ill patients in intensive care units (ICUs) often acquire opportunistic infections or are colonized by vancomycin-resistant enterococci (VRE), which limits therapeutic options and results in high case-fatality rates. In clinical practice, the beneficial effects of universal chlorhexidine gluconate (CHG) bathing on the control of VRE remain unclear. This study aimed to investigate whether 2% CHG daily bathing reduced the acquisition of VRE in the setting of a medical ICU (MICU) with VRE endemicity. Methods This quasi-experimental intervention study was conducted in a 23-bed MICU of a tertiary care hospital in Korea from September 2016 to December 2017. In a prospective, interrupted time-series analysis (ITS) with a 6-month CHG bathing intervention, we compared the acquisition and incidence of VRE and the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Acinetobacter baumannii (CRAB) between the pre-intervention and intervention periods. The primary and secondary outcomes were a change in the acquisition of VRE and incidence of VRE, MRSA, or CRAB between the two periods, respectively. Results All the adult patients admitted to the MICU were enrolled in the pre-intervention (n = 259) and intervention (n = 242). The overall CHG daily bathing compliance rate was 72.5%. In the ITS, there was a significant intervention effect with a 58% decrease in VRE acquisition (95% CI 7.1–82.1%, p = 0.038) following the intervention. However, there was no significant intervention effects on the incidence trend of VRE, MRSA, and CRAB determined by clinical culture between the pre-intervention and intervention periods. Conclusion In this real-world study, we concluded that daily bathing with CHG may be an effective measure to reduce VRE cross-transmission among patients in MICU with a high VRE endemicity.
format	article
author	Jin Woong Suh Nam Hee Kim Min Jung Lee Seoung Eun Lee Byung Chul Chun Chang Kyu Lee Juneyoung Lee Jong Hun Kim Sun Bean Kim Young Kyung Yoon Jang Wook Sohn Min Ja Kim
author_facet	Jin Woong Suh Nam Hee Kim Min Jung Lee Seoung Eun Lee Byung Chul Chun Chang Kyu Lee Juneyoung Lee Jong Hun Kim Sun Bean Kim Young Kyung Yoon Jang Wook Sohn Min Ja Kim
author_sort	Jin Woong Suh
title	Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study
title_short	Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study
title_full	Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study
title_fullStr	Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study
title_full_unstemmed	Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study
title_sort	real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (vre) in a medical intensive care unit with vre endemicity: a prospective interrupted time-series study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/03cf2bc02ea84ee28758dae26572504f
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Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study

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