Understanding chlorhexidine decolonization strategies

Excerpt

An estimated 4.5 % of acute care hospital stays are complicated by a health care-associated infection (HAI) making infection the most common complication among hospitalized patients. Critically ill patients are at greatest risk for HAIs, and these infections are associated with worse outcomes including increased morbidity, higher rates of death [1] and increased health care costs [2]. To reduce the incidence of HAIs, numerous interventions aimed at decreasing nosocomial transmission of pathogens are advocated, such as hand hygiene and isolation of patients infected or colonized with multidrug-resistant organisms (MDROs). Alternative approaches focus not on transmission of pathogens but rather on limiting reservoirs of potential pathogens on the skin, in the mouth, and gut of patients. Patients may bring these organisms with them to the hospital or become colonized after admission. Decolonization strategies target microbial reservoirs with antimicrobials, often using the broad-spectrum, topical, antimicrobial agent chlorhexidine. Here, we discuss the use of chlorhexidine for the decolonization of the mouth and skin of critically ill patients. …