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The Impact of Chlorhexidine-Based Bathing on Nosocomial Infections
This study has been completed.
First Received: March 15, 2007   No Changes Posted
Sponsors and Collaborators: Hunter Holmes Mcguire Veteran Affairs Medical Center
Weill Medical College of Cornell University
Washington University School of Medicine
Johns Hopkins University
University of Tennessee
Centers for Disease Control and Prevention
Information provided by: Hunter Holmes Mcguire Veteran Affairs Medical Center
ClinicalTrials.gov Identifier: NCT00448942
  Purpose

The purpose of this study was to determine if the use of daily chlorhexidine bathing would decrease the incidence of MRSA and VRE colonization and healthcare associated Bloodstream Infections (BSI) among Intensive Care Unit (ICU) patients.


Condition Intervention
Nosocomial Bacteremia
Nosocomial Fungemia
MRSA Colonization
MRSA Infection
VRE Colonization
VRE Infection
Behavioral: Daily bathing with Chlorhexidine based product

Study Type: Observational
Study Design: Natural History, Longitudinal, Defined Population, Retrospective Study
Official Title: The Impact of the Use of Chlorhexidine-Based Bathing System in the Hospital to Reduce the Incidence of MRSA/VRE Infection or Colonization and Nosocomial Bloodstream Infections (BSI)

Resource links provided by NLM:


Further study details as provided by Hunter Holmes Mcguire Veteran Affairs Medical Center:

Estimated Enrollment: 5300
Study Start Date: November 2004
Study Completion Date: January 2006
Detailed Description:

Infections due to Staphylococci including MRSA are the predominant nosocomially acquired complication in the intensive care unit. The increasing incidence of MRSA colonization and infection among ICU patients has been attributed to many factors including increased admission of patients already colonized with MRSA to the ICU, poor compliance with handwashing and barrier precautions, delayed identification of MRSA colonized patients, and understaffing. Measures that have proven to limit horizontal transmission between patients and staff and staff to patients include strict attention to barrier precautions and handwashing. Unfortunately both of these strategies require levels of compliance that are often not achieved. Nosocomial blood stream infections are a leading source of morbidity and mortality among intensive care unit patients. Several modifiable factors have been shown to increase the risk of bloodstream infections. These include lapses in the use of strict sterile technique in the insertion of central venous catheters and improper site preparation. New CDC guidelines on the prevention of catheter related bloodstream infections recommend that the preferential use of chlorhexidine containing skin disinfectants be used for site preparation prior to insertion. The use of chlorhexidine reduces residual skin organisms as well as inhibits their rebound growth and has been demonstrated to reduce catheter-associated bloodstream infections in comparison to other skin disinfectant products such as povidone-iodine. As a result of guidelines promoting the use of chlorhexidine, a number of intensive care units have implemented quality improvement projects examining the potential role of chlorhexidine based bathing of intensive care unit patients in reducing nosocomial transmission of multiresisitant organisms such as MRSA and vancomycin-resistant enterocooci (VRE). The goal of the currently proposed study is to analyse existing data from participating intensive care units that have adopted the use of chlorhexidine antisepsis to determine the impact of chlorhexidine on bacterial colonization and nosocomial infections Participating hospitals who have completed quality improvement projects that included the use of chlorhexidine in bathing of ICU patients will submit de-identified data on nosocomial bacteremias and MRSA and VRE colonization during defined time periods where chlorhexidine bathing was used in comparison to time periods where regular bathing procedures were utilized.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • All adult patients admitted to study units

Exclusion Criteria:

  • Children under the age of 18
  • Previous adverse reaction or documented allergy to chlorhexidine based products
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00448942

Locations
United States, Maryland
Johns Hopkins Hospital
Baltimore, Maryland, United States, 21205
United States, Missouri
Barnes Jewish Hospital
St. Louis, Missouri, United States, 63110
United States, New York
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, Virginia
Hunter Holmes McGuire Veteran Affairs Medical Center
Richmond, Virginia, United States, 23249
Sponsors and Collaborators
Hunter Holmes Mcguire Veteran Affairs Medical Center
Weill Medical College of Cornell University
Washington University School of Medicine
Johns Hopkins University
University of Tennessee
Investigators
Principal Investigator: Edward W Wong, MD Hunter Holmes Mcguire Veteran Affairs Medical Center
  More Information

No publications provided

Study ID Numbers: 01115, UR8/CCU315346-03-1
Study First Received: March 15, 2007
Last Updated: March 15, 2007
ClinicalTrials.gov Identifier: NCT00448942     History of Changes
Health Authority: United States: Federal Government;   United States: Institutional Review Board

Keywords provided by Hunter Holmes Mcguire Veteran Affairs Medical Center:
Staphylococcus aureus [B03.510.400.790.750.100]
Enterococcus faecalis [B03.510.400.800.280.280]
Enterococcus faecium [B03.510.400.800.280.300]
Bacteremia [C01.252.100]
Fungemia [C01.703.360]
Infection Control [G03.850.780.200.450]
Antisepsis [G03.850.780.200.450.150]

Study placed in the following topic categories:
Bacterial Infections
Systemic Inflammatory Response Syndrome
Anti-Infective Agents
Chlorhexidine
Bacteremia
Inflammation
Mycoses
Anti-Infective Agents, Local
Sepsis
Disinfectants
Chlorhexidine gluconate
Fungemia
Cross Infection

Additional relevant MeSH terms:
Bacterial Infections
Systemic Inflammatory Response Syndrome
Anti-Infective Agents
Communicable Diseases
Chlorhexidine
Bacteremia
Infection
Pharmacologic Actions
Inflammation
Anti-Infective Agents, Local
Mycoses
Disinfectants
Sepsis
Pathologic Processes
Chlorhexidine gluconate
Therapeutic Uses
Fungemia
Dermatologic Agents
Cross Infection

ClinicalTrials.gov processed this record on September 02, 2009