Quick Take: Chlorhexidine Versus Routine Bathing to Prevent Multidrug-Resistant Organisms and All-Cause Bloodstream Infections in General Medical and Surgical Units (ABATE Infection Trial)

Universal decontamination in the intensive care unit (ICU) has led to success in reducing bloodstream infections and infections with multi-drug resistant organisms. In this cluster-randomized trial of 53 hospitals, a similar protocol of universal decontamination using daily chlorhexidine bathing, as well as the administration of muciprocin for known methicillin-resistant staph aureus (MRSA) carriers, was investigated for its effects on infection due to multi-drug resistant organisms in non-critical-care units, as compared to routine bathing. Hospitals were randomized to deliver routine care or daily chlorhexidine bathing for all patients plus mupirocin for known MRSA carriers. The 194 non-critical-care units in 53 hospitals in the study, patients (n=156,889) were followed for infection rates, specifically for MRSA and vancomycin-resistant enterococcus (VRE). Researchers found that the chlorhexidine and muciprocin intervention led to a significant decrease in multi-drug resistant organism infections, as compared to the baseline period before the intervention (HR 0.79, 95% CI 0.73 to 0.87). However, the routine care group also saw a significant decrease in these infections, as compared to the baseline period (HR 0.87, 95% CI 0.79 to 0.95). No significant difference in effect was found between the two interventions (p=0.17).  Investigators therefore concluded that daily chlorhexidine bathing, along with muciprocin for MRSA carriers, was not associated with lower multi-drug resistant organism infection rates, as compared to usual bathing.

Click to read the study in Lancet

Image: PD

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