This randomized controlled trial aims to compare the effects of two different bed bathing methods on vancomycin-resistant Enterococcus (VRE) colonization in adult intensive care unit patients. A total of 210 patients were randomly assigned to receive either daily whole-body bathing with 4% chlorhexidine gluconate solution or daily bed bathing using disposable antibacterial body wipes. VRE colonization was monitored using skin swab cultures collected on days 7, 14, and 21. The results of this study may contribute to infection prevention strategies in intensive care units by identifying effective hygiene practices for reducing VRE colonization.

This study was designed as a randomized controlled trial conducted in the general intensive care units of a tertiary care hospital. Adult patients meeting the inclusion criteria were randomly assigned to one of two parallel groups. The experimental group received daily whole-body bed bathing with a 4% chlorhexidine gluconate solution, while the control group received daily bed bathing using disposable antibacterial body cleansing wipes.

Randomization was performed to ensure comparable baseline characteristics between the groups. VRE colonization was assessed through skin swab cultures obtained at baseline and subsequently on days 7, 14, and 21. The primary outcome of the study was the rate of VRE colonization over time. Secondary analyses included the evaluation of patient-related factors such as age, length of stay, body mass index, and previous VRE history.

All procedures were performed by trained nursing staff according to standardized protocols. The study was conducted following ethical approval obtained from the institutional ethics committee, and informed consent was obtained in accordance with ethical standards. The findings of this study aim to support evidence-based infection control practices in intensive care nursing.

Inclusion Criteria:

• Adult patients aged 18 years and older
• Patients admitted to the intensive care unit
• Expected ICU stay of at least 48 hours
• Patients requiring daily bed bathing

Exclusion Criteria:

• Known hypersensitivity to chlorhexidine
• Extensive skin lesions or burns
• Patients colonized or infected with VRE at ICU admission
• Pregnancy

Individual participant data (IPD) will not be shared. This study was conducted as a single-center academic randomized controlled trial, and the informed consent and ethics committee approval did not include provisions for public data sharing. All data are analyzed and reported in aggregate form to protect participant confidentiality.

All randomized participants were included in the baseline characteristics analysis (CHG bathing: n=105; disposable antibacterial wipes: n=105).

Day 1 through Day 21

Adverse events were systematically assessed from Day 1 through Day 21 during the ICU stay and recorded according to the study protocol.

This study was conducted in a single center intensive care unit setting, which may limit the generalizability of the findings to other institutions and patient populations. In addition, microbiological follow-up was limited to predefined sampling days (baseline, day 7, day 14, and day 21), and potential confounding clinical factors may have influenced VRE colonization outcomes.