Korea: Data from a real-world study showed that among patients in medical ICU (MICU) with a high vancomycin-resistant enterococci (VRE) endemicity, daily bathing with chlorhexidine gluconate (CHG) might be effective for reducing VRE cross-transmission. The study appears in the journal Antimicrobial Resistance & Infection Control.
In this era of antimicrobial resistance, patients in ICUs often acquire opportunistic infections or are colonized by vancomycin-resistant enterococc that limits the treatment options and leads to high fatality rates. However, the beneficial effects of universal CHG bathing on the control of VRE in clinical practice remains unclear. To clarify the same, Min Ja Kim, Korea University College of Medicine, Seoul, Republic of Korea, and colleagues aimed to investigate whether 2% CHG daily bathing reduced the acquisition of VRE in the setting of a medical ICU with VRE endemicity in a quasi-experimental intervention study.
The study was conducted in a tertiary care hospital in Korea from September 2016 to December 2017. The researchers compared the acquisition and incidence of VRE and the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Acinetobacter baumannii (CRAB) between the pre-intervention and intervention periods with a 6-month CHG bathing intervention.
The primary and secondary outcomes were a change in the acquisition of VRE and incidence of VRE, MRSA, or CRAB between the two periods, respectively.
259 patients were enrolled in the pre-intervention and 242 in the intervention.
Study's key findings include:
The overall CHG daily bathing compliance rate was 72.5%.
In the ITS, there was a significant intervention effect with a 58% decrease in VRE acquisition following the intervention.
There was no significant intervention effects on the incidence trend of VRE, MRSA, and CRAB determined by clinical culture between the pre-intervention and intervention periods.
"Our results showed that daily bathing with 2% CHG at a compliance rate of 72.5% could be an effective adjunctive control measure for reducing the acquisition rate of VRE in the ICU where VRE is endemic," the authors wrote.
Reference:
Suh, J.W., Kim, N.H., Lee, M.J. et al. Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study. Antimicrob Resist Infect Control 10, 160 (2021). https://doi.org/10.1186/s13756-021-01030-6