10 janvier 2024

Chlorhexidine bathing routine reduces infections in nursing homes

A new study funded by the Agency for Healthcare Research and Quality (AHRQ) found that nursing homes using a chlorhexidine bathing routine to clean the skin and nose with over-the-counter antiseptic solutions prevents serious infections and reduces the amount of antibiotic resistant organisms in the nursing home, such as methicillin-resistant Staphylococcus aureus (MRSA). The study was published in the New England Journal of Medicine.

In nursing homes using the bathing routine, known as decolonization, two residents per month avoided transfers to the hospital due to infections. These nursing homes also significantly reduced transfers to the hospital for other causes. Nearly 14,000 residents were included in the study.

[…] In this 18-month study of 28 nursing homes in California, researchers compared 14 facilities that continued their usual bathing routines (control group) to 14 facilities that used decolonization for all residents (intervention group). Decolonization included using a special soap called chlorhexidine and a nasal swab with povidone-iodine (iodophor) to remove pathogens from residents’ skin and nose. These two products have been used in healthcare for over 60 years. Nursing homes that used decolonization also saw significant reduction in the overall prevalence of multidrug-resistant organisms (MDROs) including MRSA, vancomycin-resistant Enterococci, and other resistant bacteria. No change in MDRO prevalence was detected in residents who lived in the nursing homes that used routine bathing.

Adherence to the decolonization bathing routine didn’t need to be perfect to prevent hospitalization and resistant organisms: 87 percent of nursing home staff used the antiseptic soap as intended and 67 percent used the nasal swab as intended.

www.nejm.org/doi/full/10.1056/NEJMoa2215254