The Association Between Chlorhexidine Bathing and Central Line-Associated Infections in Medical Intensive Care Units

The Association Between Chlorhexidine Bathing Every Other Day and Central Line-Associated Infections in Medical Intensive Care Units: An Observational Cohort Study

We conducted a retrospective observational cohort study assessing the relationship between regular bathing using 2% CHG wipes every other day and the occurrence of central line-associated infections (CLABSI) in patients within the medical intensive care unit (MICU).

Study Overview

• Status: Completed
• Conditions: Central Line-associated Bloodstream Infection (CLABSI)
• Intervention / Treatment: Other: Chlorhexidine bathing

Detailed Description

This study defined the post-intervention period as July 1, 2017, to June 30, 2022. During this period, one of the three medical intensive care units (MICUs) in NTUH implemented chlorhexidine gluconate (CHG) bathing as part of their daily care routine (CHG group). This decision was made in response to a higher incidence rate of vancomycin-resistant Enterococcus (VRE) bacteremia observed in that particular MICU during the preceding six months (pre-intervention period: January 1, 2017, to June 30, 2017), compared to the other two MICUs. The remaining two MICUs continued to provide usual care, which involved bathing patients with towels soaked in water and soap on a daily basis.

• Study Type: Observational
• Enrollment (Actual): 6930

Contacts and Locations

Study Locations

• Taiwan
  • Taipei, Taiwan, 100
    • National Taiwan University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Our study included all patients aged eighteen years and older who were admitted to the MICU between January 2017 and June 2022, without any exclusions based on specific disease characteristics.

Description

Inclusion Criteria:

• all patients who were admitted to the MICU between January 2017 and June 2022

Exclusion Criteria:

• patients aged under 18 years old

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
chlorhexidine group; Patients were bathed one day involving the use of wipes soaked in a 2% chlorhexidine gluconate (CHG) solution and the next day using a towel soaked with water and soap during the MICU stays.	Other: Chlorhexidine bathing; The procedure involved pouring an entire bottle (200ml) of 2% CHG solution (PBF Biotech, Taipei, Taiwan) onto a pre-packed set of eight single-use cotton wipes before each bathing session. A minimum of six wipes were required to thoroughly cover the entire body, including the bilateral upper and lower extremities, front and back of the trunk, perineum, and buttocks.
usual care group; Patients were bathed with towels soaked in water and soap on a daily basis during the MICU stays.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
central line-associated bloodstream infections	the incidence rate of intensive care unit acquired central line-associated bloodstream infections	Will be surveyed retrospectively through the study period (January 2017 to June 2022)
multidrug-resistant organisms bacteremia	the incidence of CLABSIs with blood cultures positive for multidrug-resistant organisms	Will be surveyed retrospectively through the study period (January 2017 to June 2022)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ICU length of stay	the total duration of the patient's ICU stay (days)	Will be surveyed retrospectively through the study period (January 2017 to June 2022)
hospital length of stay	the total duration of the patient's hospital stay (days)	Will be surveyed retrospectively through the study period (January 2017 to June 2022)
ICU mortality	whether the patient has died during their stay in the ICU	Will be surveyed retrospectively through the study period (January 2017 to June 2022)
hospital mortality	whether the patient has died during their stay in the hospital	Will be surveyed retrospectively through the study period (January 2017 to June 2022)

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Principal Investigator: Yi-Chen Lin, National Taiwan University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 12, 2023
• Primary Completion (Actual): April 30, 2023
• Study Completion (Actual): May 30, 2023

Study Registration Dates

• First Submitted: June 13, 2023
• First Submitted That Met QC Criteria: June 25, 2023
• First Posted (Actual): June 27, 2023

Study Record Updates

• Last Update Posted (Actual): June 27, 2023
• Last Update Submitted That Met QC Criteria: June 25, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Systemic Inflammatory Response Syndrome; Inflammation; Disease Attributes; Sepsis; Infections; Communicable Diseases; Anti-Infective Agents, Local; Anti-Infective Agents; Disinfectants; Chlorhexidine
• Other Study ID Numbers: 202302031RINC

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No