The effect of chlorhexidine on Acinetobacter baumannii in intensive care units

Measures to prevent the emergence of hospital-acquired infections (HAIs) include a daily bath with chlorhexidine gluconate (CHG). The aim of this study was to determine the effect of patients bathing daily with CHG on the bacterial colonization on patient surfaces, environmental surrounding areas, and attending healthcare workers (HCWs).

Patients were randomized by a 1:1 in two groups. Patients in group 1 were bathed daily with CHG; patients in group 2 were bathed with a placebo. Microbiological sampling of patients, environment, and HCWs were carried out on days 0, 3, and 10. The clonal relatedness of selected isolates collected was determined through pulsed-field gel electrophoresis. Clinical and demographic data were obtained from medical files.

Thirty-three patients were included (18 in group 1 and 15 in group 2). The more common species was Acinetobacter baumannii (n=144), followed by Klebsiella pneumoniae (n=81). A. baumannii was isolated more frequently on environmental surfaces in group 2 than group 1 (day 0 vs. day 3 vs. day 10; p = 0.0388). Twelve clones of A. baumannii were detected, with predominant clone A detected in patients and environmental surfaces. No pathogens were detected in HCWs.

Our data support that CHG bathing decreases A. baumannii surviving on the environmental surfaces of critically ill patients.