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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 |
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Information provided by: | Hunter Holmes Mcguire Veteran Affairs Medical Center |
ClinicalTrials.gov Identifier: | NCT00448942 |
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 |
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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) |
Estimated Enrollment: | 5300 |
Study Start Date: | November 2004 |
Study Completion Date: | January 2006 |
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.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
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 |
Principal Investigator: | Edward W Wong, MD | Hunter Holmes Mcguire Veteran Affairs Medical Center |
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 |
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] |
Bacterial Infections Systemic Inflammatory Response Syndrome Anti-Infective Agents Chlorhexidine Bacteremia Inflammation Mycoses |
Anti-Infective Agents, Local Sepsis Disinfectants Chlorhexidine gluconate Fungemia Cross Infection |
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 |