Chlorhexidine bathing in a tertiary care neonatal intensive care unit: A pilot study

Area of Science:

• Neonatal care
• Infectious disease prevention
• Dermatology

Background:

• Neonatal intensive care unit (NICU) patients are excluded from 2% chlorhexidine gluconate (CHG) recommendations due to dermal irritation concerns.
• This study aimed to evaluate the safety of 2% CHG bathing in NICU populations.

Purpose of the Study:

• To assess the safety of 2% chlorhexidine gluconate (CHG) bathing for neonatal intensive care unit (NICU) patients.
• To determine if CHG bathing can be safely implemented for skin cleansing in this vulnerable population.

Main Methods:

• A stepwise enrollment of infants into term, near-term, and pre-term groups was conducted.
• Infants received thrice-weekly baths using 2% CHG-impregnated washcloths, with daily skin examinations.
• A propensity score-adjusted regression model compared outcomes with a matched control cohort.

Main Results:

• No skin reactions were observed across term, near-term, and pre-term groups during 661 days of treatment.
• Despite the intervention group being generally sicker, bloodstream infection rates were similar between groups.

Conclusions:

• Two percent chlorhexidine gluconate (CHG) bathing is safe for infants over 30 weeks gestational age and 3 days old in the NICU.
• Large multicenter studies are required to establish the effectiveness of 2% CHG bathing for reducing bloodstream infections in NICU patients.