The effect of chlorhexidine bathing on MRSA and VRE colonization in inpatients of hematology-oncology patients

The purpose of this cross-over design experimental study was to evaluate the effects of chlorhexidine gluconate bathing on methicillin-resistant Staphylococcus aureus and / or vancomycin-resistant Enterococcus colonization in the hematology-oncology inpatients in ICU. To be realized the research, the necessary permissions were taken from Hacettepe University Clinical Researches Ethics Boards, T.C. Ministry of Health, Turkey Pharmaceuticals and Medical Devices Agency, hospital Head Chief, Nursing Services Directorate and Division of Intensive Care, and patients/patients relatives. This study was conducted in Hacettepe University Oncology Hospital Intensive Care Unit between September 2018-July 2019. The study sample was randomized in two arms; 31 patients for the first arm and 30 patients for the second arm. The patients in the first arm were applied bathing with water + soap for the first three days and then with 2% chlorhexidine gluconate solution for three days. The interventions were administered to the patients in the second arm in reverse order. There was a washout day given in both arms between bath interventions. Nasal, groin and rectal swap samples were taken before and after bathing (4-6 hours) in arms. Demographic characteristics and risk factors of patients in both arms were similar. Nasal methicillin-resistant Staphylococcus aureus colonization during the first arm control period decreased in the intervention period (p <.001). In comparison between arms; methicillin-resistant Staphylococcus aureus colonization in the first arm nose samples and vancomycin-resistant Enterococcus colonization in rectal samples were higher than the second arm (p <.05). In swap samples taken during water + soap bath; nasal methicillin-resistant Staphylococcus aureus colonization and rectal vancomycin-resistant Enterococcus colonization were observed in the first arm, while no colonization was observed in the second arm (p <.05). This study concluded that chlorhexidine gluconate wiping bath was effective in reducing nasal methicillin-resistant Staphylococcus aureus colonization and rectal vancomycin-resistant Enterococcus colonization in the inpatient hematology-oncology patients in intensive care unit. The use of chlorhexidine gluconate baths is recommended to reduce and prevent methicillin-resistant Staphylococcus aureus and / or vancomycin-resistant Enterococcus colonization in hematology-oncology patients.