Featured Research

from universities, journals, and other organizations

Surgical Scrub Solution: Chlorhexidine Bathing Is Cheap And Effective Means Of Protecting Patients From Superbugs

Date:
September 8, 2009
Source:
Johns Hopkins Medical Institutions
Summary:
Giving critically ill hospital patients a daily bath with a mild, soapy solution of the same antibacterial agent used by surgeons to "scrub in" before an operation can dramatically cut down, by as much as 73 percent, the number of patients who develop potentially deadly bloodstream infections, according to a new study by patient safety experts.

Surgeon washing his hands before an operation.
Credit: iStockphoto

Giving critically ill hospital patients a daily bath with a mild, soapy solution of the same antibacterial agent used by surgeons to “scrub in” before an operation can dramatically cut down, by as much as 73 percent, the number of patients who develop potentially deadly bloodstream infections, according to a new study by patient safety experts at The Johns Hopkins Hospital and five other institutions.

Related Articles


Bloodstream infections, they say, strike as many as one in five patients in hospital intensive care units and up their chances of dying by as much 25 percent. Even when they are not fatal, such infections have been reported to lengthen hospital stays by an average of a full week and add as much as $40,000 in costs.

The new study, described this summer in the June issue of the journal Critical Care Medicine, tracked daily neck-to-toe sponge baths with a mild, 4 percent solution of chlorhexidine glutonate, given to 2,650 ICU patients at six different U.S. hospitals. Chlorhexidine glutonate is the same antibacterial agent used by surgeons while scrubbing in for an operation and by dentists as a potent mouthwash to guard against gum disease. Weekly swab testing found 32 percent fewer patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) and 50 percent fewer cases of vancomycin-resistant Enterococci (VRE), when compared to a similar number of ICU patients (2,670) at the same hospitals who were washed with just plain soap and water. MRSA and VRE are the two most common so-called hospital superbugs.

“Doing everything possible to ward of bloodstream infections and halt the spread of these dangerous bacteria is essential to safeguarding our patients’ well-being, encouraging their speedy recovery and sparing valuable hospital resources,” says study co-investigator Trish Perl, M.D., director of hospital epidemiology and infection control at Johns Hopkins.

“It’s just as important to find the right soap to prevent infection as it is to find the right drug to treat patients who develop an infection,” says Perl, a professor of medicine and pathology at the Johns Hopkins University School of Medicine.

“Our results show that using chlorhexidine [glutonate] as a daily washing agent is a simple, effective and relatively cheap way to protect the health of our most vulnerable patients,” she adds, noting that various products cost very little. A 320-ounce bottle of the scrub solution costs as little as $6 a bottle, while 15 milliliter packets cost 33 cents each. It is also available as either a solid reddish-colored bar or an even milder baby-wipe type cloth containing a 2 percent chlorhexidine glutonate solution (at a cost of $2.57 for a pack of two.)

Perl says the goal is to “actively remove” bacteria that may be harmful to the patient or other patients in the hospital, people at greater risk of infection because of a weakened immune system or from use of medical devices that may offer a route for bacteria to enter the body.

“Because these bacteria have built up resistance to many of the most common antibiotic drugs used to kill them, our goal is to stop them from infecting patients or from spreading from patient to patient, as we are left with few options for treatment after they colonize and then infect a patient,” says Perl, who points out that the chemical’s antibacterial effects can last from six to 48 hours, depending on the strength of the solution.

“And altering the daily bathing routine is a simple and effective means of doing so because it involves no additional workload for nurses,” she says.

The study showed no skin rashes or adverse events during the test period, between December 2004 and January 2006. Each critically ill patient was tested for infectious bacteria within 48 hours of admission and then weekly thereafter with either nasal or buttock swabs, and for the remainder of their hospital stay.

Among some 500 patients whose stay in hospital was long (at least 10 days), 11 who were washed with chlorhexidine had MRSA and five developed bloodstream infections. By contrast, MRSA was detected in 27 of a similar group who were bathed with plain soap, with eight developing bloodstream infections. Similarly, with VRE, nine patients in the chlorhexidine group had bloodstream infections, while 33 were infected in the plain-soap group.

As part of routine hospital procedures, any patients found to be infected or to be a carrier before infection has set in are placed in isolation for the remainder of their stay. Wound care is done only in designated, confined treatment spaces or separate rooms, and hospital staff must take special precautions between treatments, such as cleaning equipment and furniture with strong disinfectants and wearing disposable gloves, masks and gowns.

Perl says chlorhexidine has been in use since the 1950s, but its practical value had “not been appreciated” until now, citing the chemical’s occasional use as a treatment for recurrent pimples as the main reason why the multicenter research team conducted the latest study.

“Our research is particularly important for preventing MRSA and other drug-resistant infections in children,” she adds. Her team’s previous research in 2007 showed that children admitted to Hopkins are increasingly identified as harboring MRSA or VRE, with four times as many children admitted to the pediatric ICU with MRSA and twice as many with VRE than five years ago.

In 2006, the Joint Commission estimated that 70 percent of the bacteria that cause infections for 2 million hospitalized Americans each year are resistant to at least one of the drugs most commonly used to treat them.

Perl’s only caution is the need for long-term monitoring to make sure that hampering the growth of one kind of bacteria -- both S. aureus and Enterococci or so-called gram-positive bacteria -- does not promote the growth of other kinds, specifically, gram-negative bacteria.

Funding for the study was provided by the U.S. Centers for Disease Control and Prevention (CDC). Besides Perl, another Hopkins researcher involved in this survey was Kathleen Speck. Investigators elsewhere included lead investigator Michael Climo, M.D., Jaime Robles, Ph.D., and Edward Wong, M.D., all at the Commonwealth University Medical Center, in Richmond, Va., with Climo and Wong also based at the Hunter Holmes McGuire Veteran Affairs Medical Center, also in Richmond; Kent Sepkowitz, M.D., and Gianna Zuccotti, M.P.H., at Memorial Sloan-Kettering Cancer Center in New York; Victoria Fraser, M.D., and David Warren, M.D., at Washington University School of Medicine in St. Louis, Mo.; and John Jernigan, M.D., at the CDC.

For additional information, please go to:

The Johns Hopkins Hospital’s Office of Hospital Epidemiology and Infection Control: http://www.hopkinsmedicine.org/heic


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "Surgical Scrub Solution: Chlorhexidine Bathing Is Cheap And Effective Means Of Protecting Patients From Superbugs." ScienceDaily. ScienceDaily, 8 September 2009. <www.sciencedaily.com/releases/2009/09/090904103351.htm>.
Johns Hopkins Medical Institutions. (2009, September 8). Surgical Scrub Solution: Chlorhexidine Bathing Is Cheap And Effective Means Of Protecting Patients From Superbugs. ScienceDaily. Retrieved November 23, 2014 from www.sciencedaily.com/releases/2009/09/090904103351.htm
Johns Hopkins Medical Institutions. "Surgical Scrub Solution: Chlorhexidine Bathing Is Cheap And Effective Means Of Protecting Patients From Superbugs." ScienceDaily. www.sciencedaily.com/releases/2009/09/090904103351.htm (accessed November 23, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, November 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com
WFP: Ebola Risks Heightened Among Women Throughout Africa

WFP: Ebola Risks Heightened Among Women Throughout Africa

AFP (Nov. 21, 2014) Having children has always been a frightening prospect in Sierra Leone, the world's most dangerous place to give birth, but Ebola has presented an alarming new threat for expectant mothers. Duration: 00:37 Video provided by AFP
Powered by NewsLook.com
Could Your Genes Be The Reason You're Single?

Could Your Genes Be The Reason You're Single?

Newsy (Nov. 21, 2014) Researchers in Beijing discovered a gene called 5-HTA1, and carriers are reportedly 20 percent more likely to be single. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins