Open AccessDifferential Effects of Chlorhexidine Skin Cleansing Methods on Residual Chlorhexidine Skin Concentrations and Bacterial Recovery
Author(s) -
Yoona Rhee,
Louisa J. Palmer,
Koh Okamoto,
Sean Gemunden,
Khaled Hammouda,
Sarah K. Kemble,
Michael Lin,
Karen Lolans,
Louis Fogg,
Derek Guanaga,
Deborah S. Yokoe,
Robert A. Weinstein,
György Frendl,
Mary K. Hayden,
Prevention Epicenter Program
Publication year - 2018
Publication title -
infection control and hospital epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.243
H-Index - 138
eISSN - 1559-6834
pISSN - 0899-823X
DOI - 10.1017/ice.2017.312
Subject(s) - chlorhexidine gluconate , antiseptic , medicine , chlorhexidine , bathing , blisters , intensive care unit , forearm , surgery , dentistry , pathology , immunology
BACKGROUND Bathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)-impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results. OBJECTIVE To determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin. DESIGN Prospective, randomized 2-center study with blinded assessment. PARTICIPANTS AND SETTING Healthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016. INTERVENTION Cleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non-antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C). RESULTS In total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001). CONCLUSION In healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined. Infect Control Hosp Epidemiol 2018;39:405-411.