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https://www.readbyqxmd.com/read/29610200/efref-and-the-transcription-regulator-chlr-are-required-for-chlorhexidine-stress-response-in-enterococcus-faecalis-v583
#1
Farry J Li, Kelli L Palmer
Enterococcus faecalis is an opportunistic pathogen and leading cause of healthcare-associated infections. Daily chlorhexidine gluconate (CHG) bathing of patients is generally regarded as an effective strategy to reduce the occurrence of healthcare-associated infections. It is likely that E. faecalis are frequently exposed to inhibitory and sub-inhibitory CHG in clinical settings. The goal of this study was to investigate how the vancomycin-resistant strain E. faecalis V583 transcriptionally responds to and tolerates stress from CHG...
April 2, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29580304/impact-of-discontinuing-contact-precautions-for-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococcus-an-interrupted-time-series-analysis
#2
Gonzalo Bearman, Salma Abbas, Nadia Masroor, Kakotan Sanogo, Ginger Vanhoozer, Kaila Cooper, Michelle Doll, Michael P Stevens, Michael B Edmond
OBJECTIVETo investigate the impact of discontinuing contact precautions among patients infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) on rates of healthcare-associated infection (HAI). DESIGN: Single-center, quasi-experimental study conducted between 2011 and 2016.METHODSWe employed an interrupted time series design to evaluate the impact of 7 horizontal infection prevention interventions across intensive care units (ICUs) and hospital wards at an 865-bed urban, academic medical center...
June 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29493475/differential-effects-of-chlorhexidine-skin-cleansing-methods-on-residual-chlorhexidine-skin-concentrations-and-bacterial-recovery
#3
Yoona Rhee, Louisa J Palmer, Koh Okamoto, Sean Gemunden, Khaled Hammouda, Sarah K Kemble, Michael Y Lin, Karen Lolans, Louis Fogg, Derek Guanaga, Deborah S Yokoe, Robert A Weinstein, Gyorgy Frendl, Mary K Hayden
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...
April 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29336763/methicillin-resistant-staphylococcus-aureus-in-a-trauma-population-does-decolonization-prevent-infection
#4
RANDOMIZED CONTROLLED TRIAL
Robert A Maxwell, Chasen A Croft, C Buddy Creech, Isaac Thomsen, Nicole Soper, Laura E Brown, Vicente A Mejia, Benjamin W Dart, Donald E Barker
The purpose of this study was to determine if a decolonization regimen reduces the frequency of methicillin-resistant Staphylococcus aureus (MRSA) infections and if colonization isolates are genetically related to subsequent infectious strains. Trauma patients admitted to the intensive care unit with positive MRSA nasal swabs were randomized to either daily chlorhexidine gluconate (CHG) baths and mupirocin (MUP) ointment to the nares or soap and water baths and placebo ointment for five days. Nasal swabs performed at the end of treatment and invasive MRSA infections during the remaining hospitalization were compared with the original nasal isolate via polymerase chain reaction for genetic relatedness as well as CHG and MUP resistance genes...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29306970/preoperative-decolonization-to-reduce-infections-in-urgent-lower-extremity-repairs
#5
Daniel S Urias, Merin Varghese, Thomas Simunich, Shawna Morrissey, Russell Dumire
PURPOSE: Medical implants and surgical site infections (SSIs) can be a burden on both patients and healthcare systems with a significant rise in morbidity, mortality and costs. Preoperatively, our practice of a chlorohexidine gluconate (CHG) washcloth bath or solution shower was supplemented with nasal painting using povidone-iodine skin and nasal antiseptic (PI-SNA). We sought to measure the effectiveness in reducing SSIs in patients undergoing repair of lower extremity fractures. METHODS: A retrospective review of trauma patients undergoing orthopedic operations conducted at Conemaugh Memorial Medical Center from 10/1/2012 through 9/30/2016...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29078249/-prevention-of-surgical-site-infections-with-special-focus-on-vascular-surgery
#6
Peter Bischoff, Petra Gastmeier
Background Surgical site infections range between the most commonly and second most commonly reported health-care-associated infections worldwide, depending on the analysis. They are associated with increased morbidity and mortality. Not only for the individual patient, the negative consequences of acquiring a surgical site infection affect the patient's relatives, the hospital and health systems in general. In vascular surgery, gram-positive pathogens of the normal flora of the patient's skin and mucosa (nose/throat) represent the almost half of the number of pathogens detected at the infected surgical site...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28993110/chlorhexidine-gluconate-bathing-practices-and-skin-concentrations-in-intensive-care-unit-patients
#7
Haleema Alserehi, Mala Filippell, Michele Emerick, Marie Kristine Cabunoc, Michael Anne Preas, Corey Sparkes, J Kristie Johnson, Surbhi Leekha
In this 2-phase real-world evaluation of chlorhexidine gluconate (CHG) skin concentrations in intensive care unit patients, we found lower skin CHG concentrations when rinsing with water after CHG solution bath (compared with no rinse), but no significant difference in concentrations between the use of CHG solution without rinse and preimpregnated CHG wipes. CHG concentration audits could be useful in assessing the quality of bathing practice, and CHG solution without rinsing may be an alternative to preimpregnated CHG wipes...
February 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/28989508/the-utility-of-electronic-health-record-based-hygiene-notes-for-chlorhexidine-bathing-practice-evaluation
#8
Valeriya Kettelhut, Trevor Van Schooneveld, James McClay, Ann Fruhling, Kathryn Dempsey
BACKGROUND: Unreliable compliance with infection prevention procedures necessitates an analysis of contributing factors. METHODS: A retrospective study explored utility of 3236 nursing hygiene notes in the electronic healthcare record system (EHR). This 2012-2013 study identified defects in the chlorhexidine (CHG) bathing practice for a hospital unit. RESULTS: The overall compliance with CHG bathing was 22.99%. Patients with length of stay less than 3 days, in most cases, did not have documentation for CHG bathing...
March 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/28803661/daily-bathing-strategies-and-cross-transmission-of-multidrug-resistant-organisms-impact-of-chlorhexidine-impregnated-wipes-in-a-multidrug-resistant-gram-negative-bacteria-endemic-intensive-care-unit
#9
Jesus Ruiz, Paula Ramirez, Esther Villarreal, Monica Gordon, Inmaculada Saez, Alfonso Rodríguez, María Jesús Castañeda, Álvaro Castellanos-Ortega
BACKGROUND: Health-care associated infections are a major cause of morbidity and mortality in critical care units. The aim of this study is to evaluate the effectiveness of chlorhexidine gluconate (CHG)-impregnated wipes in the daily bathing of patients in an intensive care unit (ICU) to prevent cross-transmission and colonization by multidrug-resistant organisms (MDROs) METHODS: Prospective cohort study with an intervention of 11 months. The intervention consisted of using CHG-impregnated wipes for the daily bathing of patients on mechanical ventilation or colonized by MDROs...
October 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28762227/-chlorhexidine-bed-bath-improves-clabsi-a-meta-analysis
#10
Shu-Cing Lin, Chair-Hua Lin, Chin-Ching Yu
BACKGROUND: Central catheters are used primarily in ICU settings. Bloodstream infections in the central line of central catheters have been shown to cause longer hospital stays for patients and result in higher medical costs. PURPOSE: The present study applies a systematic review and meta-analysis to assess the effect of a 2% chlorhexidine (CHG) bed-bath on the risk of central line-associated bloodstream infections (CLABSI). METHODS: The Public Health Resource Unit of England issued the Critical Appraisal Skills Programme and evaluated the standardized crucial appraisal tools from the Joanna Briggs Institute that are used to assess methodological quality...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28431846/implementation-of-daily-chlorhexidine-bathing-to-reduce-colonization-by-multidrug-resistant-organisms-in-a-critical-care-unit
#11
Jackson S Musuuza, Ajay K Sethi, Tonya J Roberts, Nasia Safdar
BACKGROUND: Colonized patients are a reservoir for transmission of multidrug-resistant organisms (MDROs). Not many studies have examined the effectiveness of daily chlorhexidine gluconate (CHG) bathing under routine care conditions. We present a descriptive analysis of the trends of MDRO colonization following implementation of daily CHG bathing under routine clinical conditions in an intensive care unit (ICU). METHODS: From May 2010-January 2011, we screened patients admitted to a 24-bed ICU for and methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and fluoroquinolone-resistant gram-negative bacilli (FQRGNB)...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28397616/analysis-of-multidrug-resistant-organism-susceptibility-to-chlorhexidine-under-usual-clinical-care
#12
Jackson S Musuuza, Ajay K Sethi, Tonya J Roberts, Nasia Safdar
Increasing use of daily chlorhexidine gluconate (CHG) bathing can potentially lead to selection for organisms with reduced susceptibility to CHG, limiting the utility of CHG. We examined reduced susceptibility to CHG of fluoroquinolone-resistant gram-negative bacilli and methicillin-resistant Staphylococcus. No evidence suggested reduced susceptibility to CHG. Infect Control Hosp Epidemiol 2017;1-3.
April 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28164098/another-look-at-chg-bathing-in-a-surgical-intensive-care-unit
#13
COMMENT
Kyle J Popovich
No abstract text is available yet for this article.
January 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28088171/assessing-the-sustainability-of-daily-chlorhexidine-bathing-in-the-intensive-care-unit-of-a-veteran-s-hospital-by-examining-nurses-perspectives-and-experiences
#14
Jackson S Musuuza, Tonya J Roberts, Pascale Carayon, Nasia Safdar
BACKGROUND: Daily bathing with chlorhexidine gluconate (CHG) of intensive care unit (ICU) patients has been shown to reduce healthcare-associated infections and colonization by multidrug resistant organisms. The objective of this project was to describe the process of daily CHG bathing and identify the barriers and facilitators that can influence its successful adoption and sustainability in an ICU of a Veterans Administration Hospital. METHODS: We conducted 26 semi-structured interviews with a convenience sample of 4 nurse managers (NMs), 13 registered nurses (RNs) and 9 health care technicians (HCTs) working in the ICU...
January 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27938986/reduction-in-hospital-associated-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococcus-with-daily-chlorhexidine-gluconate-bathing-for-medical-inpatients
#15
Christopher F Lowe, Elisa Lloyd-Smith, Baljinder Sidhu, Gordon Ritchie, Azra Sharma, Willson Jang, Anna Wong, Jennifer Bilawka, Danielle Richards, Thomas Kind, David Puddicombe, Sylvie Champagne, Victor Leung, Marc G Romney
BACKGROUND: Daily bathing with chlorhexidine gluconate (CHG) is increasingly used in intensive care units to prevent hospital-associated infections, but limited evidence exists for noncritical care settings. METHODS: A prospective crossover study was conducted on 4 medical inpatient units in an urban, academic Canadian hospital from May 1, 2014-August 10, 2015. Intervention units used CHG over a 7-month period, including a 1-month wash-in phase, while control units used nonmedicated soap and water bathing...
March 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/27918269/prevention-of-hospital-acquired-bloodstream-infections-through-chlorhexidine-gluconate-impregnated-washcloth-bathing-in-intensive-care-units-a-systematic-review-and-meta-analysis-of-randomised-crossover-trials
#16
REVIEW
Elsa Afonso, Koen Blot, Stijn Blot
We assessed the impact of 2% daily patient bathing with chlorhexidine gluconate (CHG) washcloths on the incidence of hospital-acquired (HA) and central line-associated (CLA) bloodstream infections (BSI) in intensive care units (ICUs). We searched randomised studies in Medline, EMBASE, Cochrane Library (CENTRAL) and Web of Science databases up to April 2015. Primary outcomes were total HABSI, central line, and non-central line-associated BSI rates per patient-days. Secondary outcomes included Gram-negative and Gram-positive BSI rates and adverse events...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27876075/chlorhexidine-bathing-and-health-care-associated-infections-among-adult-intensive-care-patients-a-systematic-review-and-meta-analysis
#17
REVIEW
Steven A Frost, Mari-Cris Alogso, Lauren Metcalfe, Joan M Lynch, Leanne Hunt, Ritesh Sanghavi, Evan Alexandrou, Kenneth M Hillman
BACKGROUND: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306-11, 2014; Roberts and Scott, Med Care 48(11):1026-35, 2010; Warren and Quadir, Crit Care Med 34(8):2084-9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039-46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1-70, 2014)...
November 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27861350/chlorhexidine-bathing-for-the-prevention-of-colonization-and-infection-with-multidrug-resistant-microorganisms-in-a-hematopoietic-stem-cell-transplantation-unit-over-a-9-year-period-impact-on-chlorhexidine-susceptibility
#18
Elisa Teixeira Mendes, Otavio T Ranzani, Ana Paula Marchi, Mariama Tomaz da Silva, José Ulysses Amigo Filho, Tânia Alves, Thais Guimarães, Anna S Levin, Silvia Figueiredo Costa
Health care associated infections (HAIs) are currently among the major challenges to the care of hematopoietic stem cell transplantation (HSCT) patients. The objective of the present study was to evaluate the impact of 2% chlorhexidine (CHG) bathing on the incidence of colonization and infection with vancomycin-resistant Enterococcus (VRE), multidrug-resistant (MDR) gram-negative pathogens, and to evaluate their CHG minimum inhibitory concentration (MIC) after the intervention.A quasi-experimental study with duration of 9 years was conducted...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27676109/bathing-and-beyond-current-bathing-controversies-for-newborn-infants
#19
Carolyn Lund
BACKGROUND: Bathing the newborn infant is controversial, ranging from how and when to give the newborn their first bath, whether to bathe newborns at all in the initial days of life, and how to approach bathing the hospitalized premature and full-term infant in the neonatal intensive care unit (NICU). PURPOSE: To review relevant literature about bathing newborn infants, as well as examine the controversies about bathing NICU patients including the use of daily chlorhexidine gluconate (CHG) baths...
October 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27457254/elimination-of-routine-contact-precautions-for-endemic-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococcus-a-retrospective-quasi-experimental-study
#20
COMPARATIVE STUDY
Elise M Martin, Dana Russell, Zachary Rubin, Romney Humphries, Tristan R Grogan, David Elashoff, Daniel Z Uslan
OBJECTIVE To evaluate the impact of discontinuation of contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) and expansion of chlorhexidine gluconate (CHG) use on the health system. DESIGN Retrospective, nonrandomized, observational, quasi-experimental study. SETTING Two California hospitals. PARTICIPANTS Inpatients. METHODS We compared hospital-wide laboratory-identified clinical culture rates (as a marker of healthcare-associated infections) 1 year before and after routine CP for endemic MRSA and VRE were discontinued and CHG bathing was expanded to all units...
November 2016: Infection Control and Hospital Epidemiology
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