March 15, 2010
By Anne Harding
NEW YORK (Reuters Health) – Bathing severely injured intensive-care patients with antiseptic-soaked washcloths can cut their risk of developing certain types of infections, and also seems to help keep drug-resistant bacteria at bay, new research shows.
Trauma patients are particularly vulnerable to hospital-acquired infections, Dr. Heather L. Evans of Harborview Medical Center in Seattle, one of the study’s authors, told Reuters Health.
“Many of these patients will go directly to the operating room and maybe not get the best preoperative cleansing, just because the circumstances are such that they need an immediate operation,” she explained.
Researchers had previously shown that bathing medical intensive care unit (ICU) patients with cloths containing the antiseptic chlorhexidine gluconate reduced infections with two types of drug-resistant bacteria, Evans and her team note in their report in the Archives of Surgery.
To investigate whether the cloths would be helpful for trauma ICU patients as well, the researchers used antiseptic-free disposable cloths to bathe these patients daily for six months, and then used the antiseptic cloths for another six months.
Antiseptic bathing cut the likelihood that patients would develop catheter-related bloodstream infections, as well as the risk of ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA, popularly known as a “superbug”). Such superbugs kill about 25,000 people a year in Europe and 19,000 in the United States.
Patients who had the antiseptic baths were also significantly less likely to have MRSA or another tough-to-treat bug, Acinetobacter, growing on their bodies, known medically as “colonization.”
Patients in the non-antiseptic group were at nearly triple the risk of having MRSA colonization compared to those who got the antiseptic baths. The only adverse effects that occurred were rashes in two patients.
Evans noted that all ICU patients at Harborview are now being bathed with the chlorhexidine-containing cloths. In 2007, she added, there were 20 cases of MRSA infection per every 1,000 patients admitted; now there are 7.6 for every 1,000 admissions. “That’s pretty impressive,” she said.
Still, the design of the study did not prove the new cloths were responsible for the change, and there is an expense involved: Chlorhexidine cloths cost $5.52 per bath, according to the study, while the regular bath product costs $1.23 per bath. Whether that expense is worth it for thousands of patients per year will require further study, the authors note.
Another potential concern, notes Dr. Shirin Towfigh, of Cedars-Sinai Medical Center, Los Angeles, is that using the chlorhexidine cloths could actually lead to other drug-resistant bacteria. However, Towfigh writes in an accompanying editorial, the study demonstrates important benefits.
SOURCE: Archives of Surgery, March 2010.