Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection
Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on...
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| Veröffentlicht in: | Journal of clinical medicine 2024-05, Vol.13 (9), p.2647 |
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| creator | Nahra, Raquel Darvish, Shahrzad Gandhi, Snehal Gould, Suzanne Floyd, Diane Devine, Kathy Fraimow, Henry Dibato, John E Rachoin, Jean-Sebastien |
| description | Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design. The study period was from January 2018 until February 2020 and February 2021 and June 2021. The control period (from January 2018 to May 2019) consisted of CHG bathing alone, and in the intervention period, we added 10% PI to the nares of critically ill patients. Our primary outcome is rates of nosocomial MRSA bacteremia, and our secondary outcome is central line associated blood stream infection (CLABSI) and potential cost savings. There were no significant differences in rates of MRSA bacteremia in critically ill patients. Nosocomial MRSA bacteremia was significantly lower during the intervention period on medical/surgical areas (MSA). CLABSIs were significantly lower during the intervention period in critically ill patients. There were no Staphylococcus aureus CLABSIs in critical care area (CCA)during the intervention period. The intervention showed potential significant cost savings. The application of 10% povidone iodine twice a day in addition to CHG bathing resulted in a significant decrease in CLABSIs in critically ill patients and a reduction in nosocomial MRSA in the non-intervention areas. Further trials are needed to tease out individual patients who will benefit from the intervention. |
| doi_str_mv | 10.3390/jcm13092647 |
| format | Article |
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We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design. The study period was from January 2018 until February 2020 and February 2021 and June 2021. The control period (from January 2018 to May 2019) consisted of CHG bathing alone, and in the intervention period, we added 10% PI to the nares of critically ill patients. Our primary outcome is rates of nosocomial MRSA bacteremia, and our secondary outcome is central line associated blood stream infection (CLABSI) and potential cost savings. There were no significant differences in rates of MRSA bacteremia in critically ill patients. Nosocomial MRSA bacteremia was significantly lower during the intervention period on medical/surgical areas (MSA). CLABSIs were significantly lower during the intervention period in critically ill patients. There were no Staphylococcus aureus CLABSIs in critical care area (CCA)during the intervention period. The intervention showed potential significant cost savings. The application of 10% povidone iodine twice a day in addition to CHG bathing resulted in a significant decrease in CLABSIs in critically ill patients and a reduction in nosocomial MRSA in the non-intervention areas. Further trials are needed to tease out individual patients who will benefit from the intervention.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13092647</identifier><identifier>PMID: 38731176</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Bacteremia ; Causes of ; Chlorhexidine ; Critical care ; Critically ill ; Dosage and administration ; Drug therapy ; Health aspects ; Hospital patients ; Hospitals ; Medical research ; Medicine, Experimental ; Methicillin ; Microorganisms ; Mortality ; Mupirocin ; Nosocomial infections ; Organisms ; Patient outcomes ; Patients ; Povidone ; Quality control ; Staphylococcus aureus ; Staphylococcus aureus infections ; Staphylococcus infections ; Supplies</subject><ispartof>Journal of clinical medicine, 2024-05, Vol.13 (9), p.2647</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c379t-1cf4de4fdc1e57d697a969abd51b5fe03781e9c769b9ac5d81c5bb66b703adbb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38731176$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nahra, Raquel</creatorcontrib><creatorcontrib>Darvish, Shahrzad</creatorcontrib><creatorcontrib>Gandhi, Snehal</creatorcontrib><creatorcontrib>Gould, Suzanne</creatorcontrib><creatorcontrib>Floyd, Diane</creatorcontrib><creatorcontrib>Devine, Kathy</creatorcontrib><creatorcontrib>Fraimow, Henry</creatorcontrib><creatorcontrib>Dibato, John E</creatorcontrib><creatorcontrib>Rachoin, Jean-Sebastien</creatorcontrib><title>Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design. The study period was from January 2018 until February 2020 and February 2021 and June 2021. The control period (from January 2018 to May 2019) consisted of CHG bathing alone, and in the intervention period, we added 10% PI to the nares of critically ill patients. Our primary outcome is rates of nosocomial MRSA bacteremia, and our secondary outcome is central line associated blood stream infection (CLABSI) and potential cost savings. There were no significant differences in rates of MRSA bacteremia in critically ill patients. Nosocomial MRSA bacteremia was significantly lower during the intervention period on medical/surgical areas (MSA). CLABSIs were significantly lower during the intervention period in critically ill patients. There were no Staphylococcus aureus CLABSIs in critical care area (CCA)during the intervention period. The intervention showed potential significant cost savings. The application of 10% povidone iodine twice a day in addition to CHG bathing resulted in a significant decrease in CLABSIs in critically ill patients and a reduction in nosocomial MRSA in the non-intervention areas. Further trials are needed to tease out individual patients who will benefit from the intervention.</description><subject>Bacteremia</subject><subject>Causes of</subject><subject>Chlorhexidine</subject><subject>Critical care</subject><subject>Critically ill</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Health aspects</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Methicillin</subject><subject>Microorganisms</subject><subject>Mortality</subject><subject>Mupirocin</subject><subject>Nosocomial infections</subject><subject>Organisms</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Povidone</subject><subject>Quality control</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus aureus infections</subject><subject>Staphylococcus infections</subject><subject>Supplies</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkk2LFDEQhhtR3GXdk3cJeBFkdpNJp9M5jo0fA8O6oJ6bfFScDOlOm_SI-4P8n9bsh8yKySFF8bxvVZKqqpeMXnCu6OXODoxTtWxq-aQ6XVIpF5S3_OlRfFKdl7KjuNq2XjL5vDrhreSMyea0-r0eJm1nkjy5Tj-DSyOQ1TTFYPUc0kjmRK50hkLCSFbOhYdkt40pb-FXcAEV7_S8PRBdRsDqGG_IOkZyjR4wzoWg5iqVZNMQdETazpABY6JHRzpEMqY3t04xJUe-zBn0QNajB3uo-KJ65nUscH5_nlXfPrz_2n1abD5_XHerzcJyqeYFs752UHtnGQjpGiW1apQ2TjAjPFAuWwbKykYZpa1wLbPCmKYxknLtjOFn1Zs73ymnH3socz-EYiFGPULal55TwRWatA2ir_9Bd2mfR-zulmK1EOKI-q4j9GH0Ca9qD6b9SiouGrGkFKmL_1C4HT6SxS_xAfOPBG_vBDanUjL4fsph0PmmZ7Q_zEV_NBdIv7pvdW8GcH_ZhyngfwDkFLM_</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Nahra, Raquel</creator><creator>Darvish, Shahrzad</creator><creator>Gandhi, Snehal</creator><creator>Gould, Suzanne</creator><creator>Floyd, Diane</creator><creator>Devine, Kathy</creator><creator>Fraimow, Henry</creator><creator>Dibato, John E</creator><creator>Rachoin, Jean-Sebastien</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20240501</creationdate><title>Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection</title><author>Nahra, Raquel ; Darvish, Shahrzad ; Gandhi, Snehal ; Gould, Suzanne ; Floyd, Diane ; Devine, Kathy ; Fraimow, Henry ; Dibato, John E ; Rachoin, Jean-Sebastien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-1cf4de4fdc1e57d697a969abd51b5fe03781e9c769b9ac5d81c5bb66b703adbb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bacteremia</topic><topic>Causes of</topic><topic>Chlorhexidine</topic><topic>Critical care</topic><topic>Critically ill</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Health aspects</topic><topic>Hospital patients</topic><topic>Hospitals</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Methicillin</topic><topic>Microorganisms</topic><topic>Mortality</topic><topic>Mupirocin</topic><topic>Nosocomial infections</topic><topic>Organisms</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Povidone</topic><topic>Quality control</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus aureus infections</topic><topic>Staphylococcus infections</topic><topic>Supplies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nahra, Raquel</creatorcontrib><creatorcontrib>Darvish, Shahrzad</creatorcontrib><creatorcontrib>Gandhi, Snehal</creatorcontrib><creatorcontrib>Gould, Suzanne</creatorcontrib><creatorcontrib>Floyd, Diane</creatorcontrib><creatorcontrib>Devine, Kathy</creatorcontrib><creatorcontrib>Fraimow, Henry</creatorcontrib><creatorcontrib>Dibato, John E</creatorcontrib><creatorcontrib>Rachoin, Jean-Sebastien</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nahra, Raquel</au><au>Darvish, Shahrzad</au><au>Gandhi, Snehal</au><au>Gould, Suzanne</au><au>Floyd, Diane</au><au>Devine, Kathy</au><au>Fraimow, Henry</au><au>Dibato, John E</au><au>Rachoin, Jean-Sebastien</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>13</volume><issue>9</issue><spage>2647</spage><pages>2647-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design. The study period was from January 2018 until February 2020 and February 2021 and June 2021. The control period (from January 2018 to May 2019) consisted of CHG bathing alone, and in the intervention period, we added 10% PI to the nares of critically ill patients. Our primary outcome is rates of nosocomial MRSA bacteremia, and our secondary outcome is central line associated blood stream infection (CLABSI) and potential cost savings. There were no significant differences in rates of MRSA bacteremia in critically ill patients. Nosocomial MRSA bacteremia was significantly lower during the intervention period on medical/surgical areas (MSA). CLABSIs were significantly lower during the intervention period in critically ill patients. There were no Staphylococcus aureus CLABSIs in critical care area (CCA)during the intervention period. The intervention showed potential significant cost savings. The application of 10% povidone iodine twice a day in addition to CHG bathing resulted in a significant decrease in CLABSIs in critically ill patients and a reduction in nosocomial MRSA in the non-intervention areas. Further trials are needed to tease out individual patients who will benefit from the intervention.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38731176</pmid><doi>10.3390/jcm13092647</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Bacteremia Causes of Chlorhexidine Critical care Critically ill Dosage and administration Drug therapy Health aspects Hospital patients Hospitals Medical research Medicine, Experimental Methicillin Microorganisms Mortality Mupirocin Nosocomial infections Organisms Patient outcomes Patients Povidone Quality control Staphylococcus aureus Staphylococcus aureus infections Staphylococcus infections Supplies |
| title | Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection |
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