A new standard of care in the ICU? ‘Universal decolonization’ cuts BSIs 44%

January 12th, 2015

In findings that are expected to set a new standard of care in intensive care units, researchers demonstrated in a large-scale trial that a combination of chlorhexidine baths and nasal mupirocin slashed bloodstream infections (BSIs) for all pathogens by a staggering 44%.

The unpublished study has major implications for patient safety, as BSIs are among the most deadly and costly of health care associated infections (HAIs).

“I do think that this is a landmark study,” says one of the lead investigators, Edward Septimus, MD, medical director of infection control and epidemiology for the Hospital Corporation of America. Indeed, the study protocol is already being implemented across all ICUs in the Nashville-based HCA hospital chain.

“We expect to implement [this protocol] across all of our ICUs starting now and over our whole system by sometime early next year,” Septimus tells Hospital Infection Control & Prevention. “We have 165 hospitals and everywhere we have ICUs we will be implementing [this].”

Though it began primarily as an intervention against methicillin-resistant Staphylococcus aureus (MRSA), the intervention proved effective against a wide array of pathogens -- yielding benefits that appeared to exceed the researchers’ expectations.

“We are talking about bloodstream infections -- this is a big deal,” lead investigator Susan Huang, MD, MPH, FIDSA, medical director of epidemiology and infection prevention at University of California Irvine Healthcare, tells HIC. “[The findings] suggest that the reduction is across the board – gram positive bacteria, gram negative bacteria, and candida.”

The results were presented last week in San Diego at the IDWeek 2012 conference.

For more on this important story see the November 2012 issue of Hospital Infection Control & Prevention.