The Association Between Chlorhexidine Bathing and Central Line-Associated Infections in Medical Intensive Care Units

Study Overview
=================
Brief Summary
-----------------
We conducted a retrospective observational cohort study assessing the relationship between regular bathing using 2% CHG wipes every other day and the occurrence of central line-associated infections (CLABSI) in patients within the medical intensive care unit (MICU).

Detailed Description
-----------------
This study defined the post-intervention period as July 1, 2017, to June 30, 2022. During this period, one of the three medical intensive care units (MICUs) in NTUH implemented chlorhexidine gluconate (CHG) bathing as part of their daily care routine (CHG group). This decision was made in response to a higher incidence rate of vancomycin-resistant Enterococcus (VRE) bacteremia observed in that particular MICU during the preceding six months (pre-intervention period: January 1, 2017, to June 30, 2017), compared to the other two MICUs. The remaining two MICUs continued to provide usual care, which involved bathing patients with towels soaked in water and soap on a daily basis.

Official Title
-----------------
The Association Between Chlorhexidine Bathing Every Other Day and Central Line-Associated Infections in Medical Intensive Care Units: An Observational Cohort Study

Conditions
-----------------
Central Line-associated Bloodstream Infection (CLABSI)

Intervention / Treatment
-----------------
* Other: Chlorhexidine bathing


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: all patients who were admitted to the MICU between January 2017 and June 2022 Exclusion Criteria: patients aged under 18 years old

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| chlorhexidine group<br>Patients were bathed one day involving the use of wipes soaked in a 2% chlorhexidine gluconate (CHG) solution and the next day using a towel soaked with water and soap during the MICU stays. | Other: Chlorhexidine bathing<br>* The procedure involved pouring an entire bottle (200ml) of 2% CHG solution (PBF Biotech, Taipei, Taiwan) onto a pre-packed set of eight single-use cotton wipes before each bathing session. A minimum of six wipes were required to thoroughly cover the entire body, including the bilateral upper and lower extremities, front and back of the trunk, perineum, and buttocks.<br>|
| usual care group<br>Patients were bathed with towels soaked in water and soap on a daily basis during the MICU stays. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| central line-associated bloodstream infections | the incidence rate of intensive care unit acquired central line-associated bloodstream infections | Will be surveyed retrospectively through the study period (January 2017 to June 2022) | 
| multidrug-resistant organisms bacteremia | the incidence of CLABSIs with blood cultures positive for multidrug-resistant organisms | Will be surveyed retrospectively through the study period (January 2017 to June 2022) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ICU length of stay | the total duration of the patient's ICU stay (days) | Will be surveyed retrospectively through the study period (January 2017 to June 2022) | 
| hospital length of stay | the total duration of the patient's hospital stay (days) | Will be surveyed retrospectively through the study period (January 2017 to June 2022) | 
| ICU mortality | whether the patient has died during their stay in the ICU | Will be surveyed retrospectively through the study period (January 2017 to June 2022) | 
| hospital mortality | whether the patient has died during their stay in the hospital | Will be surveyed retrospectively through the study period (January 2017 to June 2022) |