367Effect of Daily Chlorhexidine (CHG) Bathing on Multidrug-resistant Organisms (MDROs) Transmission and Infection at an Intensive Care Unit (ICU)

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Background. Although daily bathing with CHG may prevent the acquisition of Gram positive MDROs (methicillin-resistant S. aureus and vancomycin-resistant enterococcus), scant data exists on the impact of this strategy for Gram negative MDROs (carbapenemase-producing K. pneumoniae, P. aeruginosa, and Acinetobacter spp). The aim of this study was to determine whether daily bathing with CHG decreased MDROs acquisition among adult medical-surgical ICU patients Methods. Since July 2010 an active surveillance protocol to identify asymptomatic colonization by MDROs at ICU admission or weekly during the patient stay, was implemented. In addition a daily bathing with no-rinse 2% CHG-impregnated washcloths was implemented at the end of 2011, reached 100% compliance from January 2012. The MDROs incoming colonization pressure and MDROs acquisition rate were estimated as the number of isolation of MDROs from surveillance or clinical culture performed less than 48 hours after admittance to the ICU per 1,000 admissions and more than 48 hours after admittance to the ICU per 1,000 patient-days, respectively. Through a prospective before and after study both indicators were compared between Period A: July 2010/December 2011 and Period B: January 2012/December 2013. In all instances non duplicated cases were considered Results. While there was an 135% increase in the incoming colonization pressure during Period B vs Period A for Gram positive MDROs (92.42 cases per 1,000 admissions vs 39.30 cases per 1,000 admissions; difference 53.12 [95% confidence interval (CI) 1.89 to 8.73]; p < 0.01) and a 90% for Gram negative MDROs (33.18 cases per 1,000 admissions vs 17.47 cases per 1,000 admissions; difference 15.71 [95% CI –5.47 to 36.88]; p < 0,15), a significant reduction was observed for the acquisition of Gram positive and Gram negative MDROs (2.40 cases per 1,000 patient-days vs 4.86 cases per 1,000 patient-days; difference –2.46 [95% CI –0.57 to –4.34]; p < 0.01; 3.86 cases per 1,000 patient-days vs 7.21 cases per 1,000 patient-days; difference –3.36 [95%CI –1.03 to –5.68]; p < 0.01, respectively) Conclusion. Daily bathing with CHG-impregnated washcloths significantly reduced the risks of acquisition of both Gram positive and negative MDROs, in spite the increase of the incoming colonization pressure rate Disclosures. All authors: No reported disclosures.

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