Chlorhexidine gluconate bathing to reduce methicillin-resistant Staphylococcus aureus acquisition

Area of Science:

• Infection Control
• Antimicrobial Resistance
• Public Health

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in intensive care units (ICUs).
• Chlorhexidine gluconate (CHG) is a broad-spectrum antiseptic effective against MRSA.
• Current bathing protocols require evaluation for optimal MRSA prevention.

Purpose of the Study:

• To assess the impact of a CHG bathing protocol on MRSA acquisition in adult ICUs.
• To compare the cost-effectiveness of the CHG bath-basin method versus prepackaged CHG wipes.

Main Methods:

• A protocol using 4% CHG solution in a bath basin was implemented in 5 adult ICUs.
• Three ICUs utilized active surveillance for MRSA acquisition.
• Two ICUs monitored for new MRSA-positive cultures within 48 hours of admission.

Main Results:

• MRSA acquisition rates decreased from 3.84 to 2.63 per 1000 patient-days post-protocol implementation (rate ratio difference: 1.46, P = .003).
• The CHG bath-basin method cost $3.18 per patient.
• Prepackaged CHG wipes were 74% more expensive at $5.52 per patient.

Conclusions:

• The CHG bathing protocol is easily implementable in diverse adult ICU settings.
• This protocol is a cost-effective strategy for reducing unit-acquired MRSA.
• The findings support the widespread adoption of this CHG bathing protocol for MRSA control.