The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit

J Perinatol. 2019 Jan;39(1):63-71. doi: 10.1038/s41372-018-0231-7. Epub 2018 Sep 20.

Abstract

Objective: To assess the impact of chlorhexidine gluconate (CHG) bathing on skin bacterial burden in neonates.

Study design: In this prospective observational study, arm and groin skin bacterial growth was measured in 40 CHG-exposed and nonexposed neonates admitted to the NICU. Exposed neonates received 2% CHG baths per protocol for central line-associated bloodstream infection (CLABSI) prevention or Staphylococcus aureus decolonization.

Results: Forty neonates were enrolled, 18 of whom were CHG-exposed. Mean baseline Gram-positive (GP) bacterial burden was 2.19 log CFU/ml on the arm and 1.81 log CFU/ml on the groin. Bacterial burden decreased after the first bath, but returned to baseline by 72 h. Residual skin CHG concentration declined over time, with a corresponding increase in GP bacterial burden.

Conclusions: CHG bathing reduces skin bacterial burden, but burden returns to baseline after 72 h. Twice weekly CHG bathing may be inadequate to suppress skin bacterial growth in hospitalized neonates.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use
  • Bacterial Load* / drug effects
  • Bacterial Load* / methods
  • Baths / methods*
  • Catheter-Related Infections* / microbiology
  • Catheter-Related Infections* / prevention & control
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Female
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Intensive Care, Neonatal / methods
  • Male
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Secondary Prevention / methods
  • Skin* / drug effects
  • Skin* / microbiology
  • Staphylococcal Infections* / etiology
  • Staphylococcal Infections* / prevention & control

Substances

  • Anti-Infective Agents, Local
  • chlorhexidine gluconate
  • Chlorhexidine