Abstract |
The prevalence of skin colonisation with Acinetobacter baumannii ( ACBA) on admission to the medical intensive care unit (MICU) was studied in an institution endemic for ACBA bloodstream infections (BSIs). The impact of 4% chlorhexidine gluconate (4% CG) whole-body washing on the patients' ACBA skin colonisation was also determined. A prospective cohort trial in a MICU during March 2002 to December 2003 was performed, with a comparison between the prevalence and incidence of ACBA-BSIs obtained after intervention and retrospectively. During the intervention period, ACBA skin-screening swabs were taken from all patients on admission and periodically until discharge. Patients underwent whole-body disinfection with 4% CG immediately after obtaining the initial cultures. Disinfection was carried out on a daily basis until discharge, regardless of colonisation status. Of the 320 patients at ward admission, 55 (17%) yielded ACBA. The prevalence of ACBA colonisation among the remaining MICU patients was 5.5% at 24h and 1% at 48h following the disinfection regimen (P=0.002, OR: 2.4). Following a second screen, 80% of colonised patients were decolonised. Prevalence of ACBA-BSIs decreased from 4.6 to 0.6 per 100 patients (P < or = 0.001; OR: 7.6) and incidence decreased from 7.8 to 1.25 (85% reduction). We conclude that daily whole-body disinfection with 4% CG significantly reduced ACBA skin colonisation. This regimen may be considered in addition to well-known infection control measures, particularly in institutions with endemic rates of multidrug-resistant ACBA-BSIs.
|
Authors | A Borer, J Gilad, N Porat, R Megrelesvilli, L Saidel-Odes, N Peled, S Eskira, F Schlaeffer, Y Almog |
Journal | The Journal of hospital infection
(J Hosp Infect)
Vol. 67
Issue 2
Pg. 149-55
(Oct 2007)
ISSN: 0195-6701 [Print] England |
PMID | 17900759
(Publication Type: Comparative Study, Journal Article)
|
Chemical References |
- chlorhexidine gluconate
- Chlorhexidine
|
Topics |
- Acinetobacter Infections
(epidemiology, prevention & control)
- Acinetobacter baumannii
(drug effects, isolation & purification)
- Chlorhexidine
(analogs & derivatives, therapeutic use)
- Cohort Studies
- Cross Infection
(prevention & control)
- Disinfection
(methods)
- Drug Resistance, Multiple, Bacterial
- Humans
- Incidence
- Intensive Care Units
- Prevalence
- Prospective Studies
- Skin
(microbiology)
|