The effect of chlorhexidine on Acinetobacter baumannii in intensive care units

Michel F.  Martinez-Resendez; Flora  Cruz-López; Natalia Gaona-Chávez; Adrián  Camacho-Ortiz; Roberto  Mercado-Longoria; Samantha  Flores-Treviño; Paola  Bocanegra-Ibarias; Elvira  Garza-González

doi:10.18502/ijm.v14i1.8796

Michel F. Martinez-Resendez Department of Internal Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico
Flora Cruz-López Department of Pharmaceutical Biological Chemistry, School of Chemistry, Autonomous University of Nuevo Leon, San Nicolas de los Garza, Nuevo León, Mexico
Natalia Gaona-Chávez Department of Internal Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico
Adrián Camacho-Ortiz Department of Internal Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico
Roberto Mercado-Longoria Department of Internal Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico
Samantha Flores-Treviño Department of Internal Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico
Paola Bocanegra-Ibarias Department of Internal Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico
Elvira Garza-González Department of Biochemistry and Molecular Medicine, School of Medicine, University Hospital ‘Dr. José Eleuterio González’, Autonomous University of Nuevo Leon, Monterrey, Nue vo León, Mexico

DOI: https://doi.org/10.18502/ijm.v14i1.8796

Keywords: Infection disease transmission; Chlorhexidine; Decontamination; Acinetobacter baumannii; Gram-negative bac- teria

Abstract

Background and Objectives: Measures to prevent the emergence of hospital-acquired infections (HAIs) include a daily bath with chlorhexidine gluconate (CHG). The aim of this study was to determine the effect of patients bathing daily with CHG on the bacterial colonization on patient surfaces, environmental surrounding areas, and attending healthcare workers (HCWs).

Materials and Methods: Patients were randomized by a 1:1 in two groups. Patients in group 1 were bathed daily with CHG; patients in group 2 were bathed with a placebo. Microbiological sampling of patients, environment, and HCWs were carried out on days 0, 3, and 10. The clonal relatedness of selected isolates collected was determined through pulsed-field gel elec- trophoresis. Clinical and demographic data were obtained from medical files.

Results: Thirty-three patients were included (18 in group 1 and 15 in group 2). The more common species was Acinetobacter baumannii (n=144), followed by Klebsiella pneumoniae (n=81). A. baumannii was isolated more frequently on environmen- tal surfaces in group 2 than group 1 (day 0 vs. day 3 vs. day 10; p = 0.0388). Twelve clones of A. baumannii were detected, with predominant clone A detected in patients and environmental surfaces. No pathogens were detected in HCWs.

Conclusion: Our data support that CHG bathing decreases A. baumannii surviving on the environmental surfaces of criti- cally ill patients.