Impact of routine chlorhexidine bathing and nasal iodophor on MDRO colonization and environmental contamination in nursing homes.

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES

Infection Control and Hospital Epidemiology Pub Date : 2025-08-22 DOI:10.1017/ice.2025.10234

Evelyn Adriana Flores, Raveena Singh, James A McKinnell, Thomas T Tjoa, Gabrielle M Gussin, Bryn Launer, Michael Bolaris, Kaye Evans, Ellena Peterson, Loren G Miller, Susan S Huang

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引用次数: 0

Abstract

Background: Nursing homes residents have a high prevalence of multidrug-resistant organism (MDRO) colonization. Recent trials demonstrated that decolonizing residents reduces infection. However, decolonization's impact on environmental MDRO contamination is not well understood.

Methods: We performed a 9-month pilot (3-month baseline, 3-month phase-in and 3-month intervention) in 3 nursing homes implementing routine chlorhexidine bathing/showering and nasal iodophor. We repeatedly tested for colonization via skin and nasal swabs for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum beta-lactamase producers (ESBLs), and carbapenem-resistant Enterobacterales (CRE). We also swabbed high-touch surfaces in rooms of MDRO carriers for MDRO fomite contamination.

Results: Decolonization decreased the odds of MDRO colonization in nursing home residents by 55% (OR 0.45, P < 0.001, raw reduction from 46% (411/900) to intervention: 29% (262/900); colonization with MRSA, VRE, and ESBL all significantly decreased (P < 0.001). Among residents who remained colonized with any MDRO, 288/330 (87%) of high-touch bedroom objects were colonized with ≥1 MDRO. In a multivariable analysis, MDRO fomite contamination in rooms of MDRO carriers was associated with antibiotic use (OR = 1.54 [95% CI: 1.19-1.98], wound presence (OR = 1.34 (95% CI: 1.02-1.77), and specific fomites such as bedside table/bedrails (OR = 12.7 (95% CI: 9.37-17.25), but not the intervention period (OR = 1.02 [0.81-1.27]).

Conclusion: Routine chlorhexidine bathing and nasal iodophor significantly reduced MDRO body colonization among nursing home residents. However, in rooms of residents who remained MDRO carriers, environmental contamination was unchanged during the decolonization intervention. Efforts to ensure fomite surface clearance in rooms of MDRO carriers may be key to reducing environmental MDRO spread.

查看原文本刊更多论文

常规洗必定沐浴和鼻腔碘伏对养老院MDRO定植和环境污染的影响。

背景：养老院居民具有高流行的多药耐药菌（MDRO）定植。最近的试验表明，非殖民化居民减少了感染。然而，非殖民化对环境中轻海运污染的影响还没有得到很好的了解。方法：我们在3家疗养院进行了为期9个月的试点（3个月的基线，3个月的阶段性和3个月的干预），实施常规洗必泰沐浴/淋浴和鼻腔碘伏。我们通过皮肤和鼻拭子反复检测耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）、广谱β -内酰胺酶产生菌（ESBLs）和耐碳青霉烯肠杆菌（CRE）的定植情况。我们还用棉签擦拭了带有MDRO载体的房间的高接触表面，以检测MDRO污染物。结果：去殖民化使MDRO在养老院居民中定植的几率降低了55% (OR 0.45, P < 0.001)，从46%（411/900）原始降低到29% (269 /900)；MRSA、VRE和ESBL的定殖均显著降低（P < 0.001）。在仍有MDRO定殖的居民中，288/330（87%）的高接触卧室物品定殖≥1个MDRO。在一项多变量分析中，MDRO携带者房间的MDRO污染物污染与抗生素使用（OR = 1.54 [95% CI: 1.19-1.98]）、伤口存在(OR = 1.34 （95% CI: 1.02-1.77）以及床头柜/床栏杆等特定污染物(OR = 12.7 （95% CI: 9.37-17.25）相关，但与干预期无关（OR = 1.02[0.81-1.27]）。结论：常规洗必定沐浴和鼻用碘伏可显著降低MDRO在养老院居民体内的定植。然而，在非殖民化干预期间，在仍然是MDRO携带者的居民房间中，环境污染没有改变。努力确保MDRO携带者房间的污染物表面清除可能是减少MDRO环境传播的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection Control and Hospital Epidemiology 医学-传染病学

CiteScore

6.40

自引率

6.70%

发文量

289

审稿时长

3-8 weeks

期刊介绍： Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.