Chlorhexidine Gluconate Bathing Reduces the Incidence of Bloodstream Infections in Adults Undergoing Inpatient Hematopoietic Cell Transplantation
| Autor: | Kristin G. Kegerreis, Antonio L.C. Gomes, Li Ma, David A. Rizzieri, Mitchell E. Horwitz, Yvonne M. Mowery, Gwynn D. Long, Sin-Ho Jung, Stefanie Sarantopoulos, Yi Ren, Erica Lobaugh-Jin, Vinay K. Giri, Richard D. Lopez, Marcel R.M. van den Brink, Deborah H. Allen, Nelson J. Chao, Martha Lassiter, Lauren Bohannon, Elizabeth Sito, Jennifer L. Saullo, Julia A. Messina, Morris Greenberg, Anita Matthews, Jonathan U. Peled, Anthony D. Sung, Cristina Gasparetto, Tessa M. Andermann, Taewoong Choi |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Bathing medicine.drug_class medicine.medical_treatment Hematopoietic stem cell transplantation Article Antiseptic Internal medicine Sepsis Chlorhexidine gluconate medicine Immunology and Allergy Humans Prospective Studies Prospective cohort study Adverse effect Transplantation Cross Infection Inpatients business.industry Incidence (epidemiology) Incidence Chlorhexidine Hematopoietic Stem Cell Transplantation Cell Biology Hematology Molecular Medicine business human activities |
| Zdroj: | Transplant Cell Ther |
| ISSN: | 2666-6367 |
| Popis: | BACKGROUND: Bloodstream infections (BSIs) occur in 20-45% of inpatient autologous and allogeneic hematopoietic cell transplant (HCT) patients. Daily bathing with the antiseptic chlorhexidine gluconate (CHG) has been shown to reduce the incidence of BSIs in critically ill patients although very few studies include HCT patients or have evaluated the impact of compliance on effectiveness. METHODS: We conducted a prospective cohort study with historical controls to assess the impact of CHG bathing on the rate of BSIs and gut microbiota composition among adults undergoing inpatient HCT at the Duke University Medical Center. We present one year of data without CHG bathing (2016) and two years of data when CHG was used on the HCT unit (2017-2018). Because not all patients adhered to CHG, patients were grouped into four categories by rate of daily CHG usage: High (>75%), Medium (50-75%), Low (1-49%), and None (0%). RESULTS: Among 192 patients, univariate trend analysis demonstrated that increased CHG usage was associated with decreased incidence of clinically-significant BSI, defined as any BSI requiring treatment by the medical team (High-8% BSI, Medium-15.2%, Low-15.6%, No CHG-30.3%, p=0.003), laboratory-confirmed BSI (LCBI, p=0.03), central line-associated BSI (CLABSI, p=0.04), and mucosal barrier injury BSI (MBI-LCBI, p=0.002), Multivariate analysis confirmed a significant effect of CHG bathing on clinically-significant BSI (p=0.023) and mucosal barrier injury BSI (MBI-LCBI, p=0.007), without consistently impacting gut microbial diversity. Benefits of CHG bathing were most pronounced with >75% daily usage, and there were no adverse effects attributable to CHG. CONCLUSIONS: Adherence to daily CHG bathing significantly decreases the rate of bloodstream infection following HCT. |
| Databáze: | OpenAIRE |
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