The Particulars: Many infections in ICUs are caused by increasingly antibiotic-resistant bacteria that live on the skin and in the nose. Although these infections are often preventable, they can cause serious complications, prolong hospital stays, and increase costs and mortality.
Data Breakdown: More than 40 hospitals participating in a study were randomized to one of three interventions. The first was to continue routine care, screen ICU patients for MRSA, and isolate those who carried it. The second group screened and isolated patients carrying MRSA and bathed them in chlorhexidine soap and applied nasal mupirocin ointment. The third group treated all ICU patients with a daily chlorhexidine bath and 5 days of nasal mupirocin ointment. Among patients randomized to the third group, the number of ICU patients carrying MRSA decreased nearly 35%, compared with no change among the other two groups. Additionally, the rate of bloodstream infections decreased from 6.1 to 3.6 per 1,000 patient days in the hospital in the third group.
Take Home Pearl: Treating all ICU patients with antimicrobial soap and ointment appears to significantly decrease their risk of developing bloodstream infections during hospitalization.