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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).
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| chlorhexidine group | 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. |
| |
| usual care group | Patients were bathed with towels soaked in water and soap on a daily basis during the MICU stays. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chlorhexidine bathing | Other | 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. |
| 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) |
| 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) |
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Inclusion Criteria:
Exclusion Criteria:
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Our study included all patients aged eighteen years and older who were admitted to the MICU between January 2017 and June 2022, without any exclusions based on specific disease characteristics.
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| Name | Affiliation | Role |
|---|---|---|
| Yi-Chen Lin | National Taiwan University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Taipei | 100 | Taiwan |
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| 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) |