Implementation of daily chlorhexidine bathing to reduce colonization by multidrug-resistant organisms in a critical care unit

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 methicillinresistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and fluoroquinoloneresistant gram-negative bacilli (FQRGNB). We calculated and plotted monthly incidence and prevalence of colonization of these MDROs. Results: Prevalence decreased in the immediate aftermath of daily CHG bathing implementation and generally remained at that level throughout the observation period. We observed low rates of incidence of MDRO colonization with VRE> FQRGNB> MRSA. Monthly prevalence of colonization and incidence for the composite of MRSA, VRE, and/or FQRGNB was 1.9%-27.9% and 0-1.1/100 patient-days, respectively. Conclusions: Following the implementation of daily CHG bathing, the incidence of MDROs remained low and constant over time, whereas the prevalence decreased immediately after the implementation. Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.