Chlorhexidine Bathing to Prevent Central Line–Associated Bloodstream Infections in Hematology Units: A Prospective, Controlled Cohort Study
| Autor: | Kuei-Lien Tien, Yen-Ping Hung, Wang-Huei Sheng, Shiouh-Chu Shieh, Hwei-Fang Tien, Yee-Chun Chen, Li-Jung Chien, Jann-Tay Wang, Chi-Tai Fang, Yi-Hsuan Chen |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Microbiology (medical) medicine.medical_specialty Bathing Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Intensive care medicine Humans Prospective Studies 030212 general & internal medicine Cross Infection Hematology business.industry Incidence (epidemiology) Chlorhexidine Hazard ratio Baths medicine.disease Intensive Care Units Infectious Diseases 030220 oncology & carcinogenesis Bacteremia Anti-Infective Agents Local business Cohort study medicine.drug |
| Zdroj: | Clinical Infectious Diseases. 71:556-563 |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Chlorhexidine (CHG) bathing decreases the incidence of bloodstream infections in intensive care units, but its effect has been understudied in patients with hematological malignancies in noncritical care units. Methods Adults with hematological malignancies hospitalized for cytotoxic chemotherapy in noncritical care units were offered daily 2% CHG bathing. We compared outcomes of patients who chose CHG bathing (CHG group) with outcomes of those who did not choose CHG bathing (usual-care group). The primary outcome was gram-positive cocci–related, skin flora–related, or central line–associated bloodstream infection. The negative control outcome was gut-origin bacteremia. Results The CHG group (n = 485) had a crude incidence rate of the primary outcome that was 60% lower than the rate for the usual-care group (n = 408; 3.4 vs 8.4 per 1000 patient-days, P = .02) but had a similar crude incidence rate of the negative control outcome (4.5 vs 3.2 per 1000 patient-days; P = .10). In multivariable analyses, CHG bathing was associated with a 60% decrease in the primary outcome (adjusted hazard ratio [HR], 0.4; P < .001). In contrast, CHG bathing had no effect on the negative control outcome (adjusted HR, 1.1; P = .781). CHG bathing was well tolerated by participants in the CHG group. Conclusions CHG bathing could be a highly effective approach for preventing gram-positive cocci–related, skin flora–related, or central line–associated bacteremia in patients with hematological malignancies who are hospitalized for cytotoxic chemotherapy in noncritical care units. |
| Databáze: | OpenAIRE |
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