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Decreasing Health Care-Associated Bloodstream Infections in Patients in the Intensive Care Unit
Christina Weyant
University of South Florida
Abstract
References
Bleasdale, S., Trick, W., Gonzalez, I., Lyles, R., Hayden, M., & Weinstein, R. (2007).
Table 1
Literature review
10
Aims
Design and
Sample
Outcomes/statistics
Measures
Randomized
N=391 in the
crossover
chlorhexidine
central venous
discover if
clinical trial
group
Weinstein, R. (2007).
patients bathed
consisting of
N= 445 in the
occurrence of
Effectiveness of
daily with
a 28 week
soap and
bloodstream
chlorhexidine bathing
chlorhexidine
intervention
water group.
infections was
to reduce catheter-
period,
N=3
significantly lower
associated bloodstream
of primary
flowed by a
excluded
in the chlorhexidine
infections in medical
bloodstream
2 week wash
from the
group compared to
infections
out period,
chlorhexidine
patients. Archives of
compared to
and then a 24
group due to
group (p=0.01)
Internal Medicine,
patients bathed
week
adverse skin
167(19), 2073-2079.
crossover
reaction.
and water.
intervention
All
period.
participants
were patients
Primary
in the
measure was
medical ICUs
primary
at John H.
bloodstream
Stroger Jr
infections
(Cook
and clinical
County)
10
11
Hospital.
The
Groups of
secondary
participants
measures
were similar.
were other
nosocomial
infections.
Climo, M., Yokoe, D.,
To ascertain the
A cluster-
effect of
randomized
participants
bathing with 2
crossover
L., . . . Wong, E.
percent
clinical trial
9 intensive
(p=0.03), hospital-
chlorhexidine
with a 6
acquired
chlorhexidine bathing
each day on
month
1 bone
bloodstream
on hospital-acquired
multidrug
intervention
marrow
infections
resistant
period, and a
transplant
(p=0.007), primary
Journal of Medicine,
organisms and
6 month
clinic
bloodstream
368(6), 533-542.
health care-
crossover
participated.
infections
significant reduction
in MRSA or VRE
doi:10.1056/NEJMoa11 associated
intervention
(p=0.006), and
13849
period.
central-catheter-
bloodstream
infections
associated
compared to
Measures
bloodstream
daily bathing
used were
infections (p=0.004)
11
12
National
in the chlorhexidine
nonantibacterial
Healthcare
group compared to
cloths.
Safety
the
Network
nonantimicrobial
definitions
group
for, hospitalacquired
bloodstream
infection,
primary
bloodstream
infections,
and central
catheterassociated
bloodstream
Huang, S., Septimus,
To compare
infections.
Cluster-
screening and
randomized
A total of
decolonization
isolation,
clinical trial
43hospitals
significantly
targeted
involving a
and 74
reduced incidence
(2013).
decolonization
12 month
intensive care
of MRSA compared
Targeted versus
with
baseline
units
with screening
universal
chlorhexidine
Universal
13
and intranasal
18 month
mupirocin, and
intervention
were
reduced incidence
universal
period.
excluded due
of bloodstream
of Medicine, 368(24),
decolonization
to exclusion
2255-2265. doi:
with
Primary
criteria, and
pathogens compared
10.1056/NEJMoa12072 chlorhexidine
outcome was
one hospital
to screening and
90
and intranasal
ICU
withdrew and
isolation (p<0.001)
mupirocin as
associated
was analyzed
and targeted
interventions
clinical
in the as-
decolonization
for bloodstream
cultures
assigned
(p=0.04).
infections
positive for
analysis
associated with
MRSA.
MRSA, and
bloodstream
Secondary
infections
outcome was
associated with
ICU
other
associated
pathogens.
bloodstream
infections
associated
with MRSA
or other
pathogens.
13
14
Center of
Disease
Control
criteria was
used.
14