Article
Infectious Diseases
Luisa A. Denkel, Frank Schwab, Jorg Clausmeyer, Michael Behnke, Jennifer Golembus, Solvy Wolke, Petra Gastmeier, Christine Geffers
Summary: The study aimed to compare the effects of chlorhexidine, octenidine, or routine bathing with water and soap on CLABSI rates in ICUs. However, both antiseptic methods did not show a significant preventive effect on CLABSI rates in the ICU setting.
CLINICAL MICROBIOLOGY AND INFECTION
(2022)
Article
Public, Environmental & Occupational Health
Staci S. Reynolds, Bradi B. Granger, Daniel Hatch
Summary: Measuring compliance with the appropriate CHG bathing process through direct observation audits can help sustain this practice, though data capture may be challenging. A study found that self-reported compliance may be an accurate, easy-to-obtain proxy measure for CHG bathing process compliance.
AMERICAN JOURNAL OF INFECTION CONTROL
(2021)
Article
Public, Environmental & Occupational Health
Luisa Denkel, Frank Schwab, Joerg Clausmeyer, Michael Behnke, Jennifer Golembus, Solvy Wolke, Petra Gastmeier, Christine Geffers
Summary: An analysis of a cluster randomised controlled trial revealed that antiseptic bathing did not reduce central-line associated bloodstream infection (CLABSI) rates in intensive care units (ICU). However, this analysis did not consider baseline infection rates. A post-hoc analysis of the trial showed that daily bathing with chlorhexidine reduced ICU-attributable CLABSI rates caused by gram-positive bacteria, while octenidine did not have a significant effect.
ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL
(2023)
Article
Immunology
Ahmed Babiker, Joseph D. Lutgring, Scott Fridkin, Mary K. Hayden
Summary: Chlorhexidine gluconate (CHG) is widely used in healthcare as an antiseptic with a good safety profile and broad spectrum of activity. Daily bathing with CHG has proven effective in preventing healthcare-associated infections and decolonizing multidrug-resistant pathogens. Despite the established benefits of CHG, concerns and unanswered questions remain regarding potential unintended microbial consequences of routine CHG bathing.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Medicine, General & Internal
Ming-Ru Lin, Po-Jui Chang, Ping-Chih Hsu, Chun-Sui Lin, Cheng-Hsun Chiu, Chih-Jung Chen
Summary: In the care bundle for central venous catheters, 2% chlorhexidine gluconate-alcohol (CHG) is superior to 10% povidone-iodine-alcohol (PVI) in inhibiting skin flora growth at insertion sites and potentially reducing the incidence of catheter-related bloodstream infections (CRBSIs).
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
T. Scheier, D. Saleschus, M. Dunic, M. R. Frohlich, R. Schupbach, C. Falk, H. Sax, S. P. Kuster, P. W. Schreiber
Summary: Daily chlorhexidine bathing can reduce the incidence of central line-associated bloodstream infections in ICU patients. However, it has limited impact on the causative pathogens.
JOURNAL OF HOSPITAL INFECTION
(2021)
Article
Multidisciplinary Sciences
Maskit Bar-Meir, Shoshana Bendelac, Irina Shchors
Summary: The aim of this study was to assess the safety of 2% chlorhexidine gluconate (CHG) bathing in NICU patients. The results showed that after 661 days of treatment on 810 newborns, no skin reactions were observed and the bloodstream infection rate was similar to the control group. It was concluded that 2% CHG bathing is safe for infants >30 weeks and >3 days old.
Article
Public, Environmental & Occupational Health
Jin Woong Suh, Nam Hee Kim, Min Jung Lee, Seoung Eun Lee, Byung Chul Chun, Chang Kyu Lee, Juneyoung Lee, Jong Hun Kim, Sun Bean Kim, Young Kyung Yoon, Jang Wook Sohn, Min Ja Kim
Summary: In this study conducted in a medical ICU with VRE endemicity, daily bathing with 2% CHG was found to significantly reduce the acquisition of VRE and cross-transmission among patients. Compliance with CHG daily bathing was 72.5%. There was a 58% decrease in VRE acquisition following the CHG intervention.
ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL
(2021)
Article
Medicine, General & Internal
Kuei-Lien Tien, Jann-Tay Wang, Wang-Huei Sheng, Hui-Ji Lin, Pao-Yu Chung, Chin-Yuan Tsan, Yi-Hsuan Chen, Chi-Tai Fang, Yee-Chun Chen, Shan-Chwen Chang
Summary: The study found that using Chlorhexidine (CHG) bathing in ICUs can significantly reduce the incidence of VRE-related healthcare-associated infections (HAIs), while standard care showed no effect on the risk of VRE-HAIs.
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
(2021)
Article
Hematology
Vinay K. Giri, Kristin G. Kegerreis, Yi Ren, Lauren M. Bohannon, Erica Lobaugh-Jin, Julia A. Messina, Anita Matthews, Yvonne M. Mowery, Elizabeth Sito, Martha Lassiter, Jennifer L. Saullo, Sin-Ho Jung, Li Ma, Morris Greenberg, Tessa M. Andermann, Marcel R. M. van den Brink, Jonathan U. Peled, Antonio L. C. Gomes, Taewoong Choi, Cristina J. Gasparetto, Mitchell E. Horwitz, Gwynn D. Long, Richard D. Lopez, David A. Rizzieri, Stefanie Sarantopoulos, Nelson J. Chao, Deborah H. Allen, Anthony D. Sung
Summary: Daily bathing with chlorhexidine gluconate (CHG) has been shown to significantly reduce the risk of bloodstream infection in patients undergoing hematopoietic cell transplant, with the greatest effect seen when daily usage is over 75%. Adherence to CHG bathing significantly decreases the rate of clinically significant bloodstream infection.
TRANSPLANTATION AND CELLULAR THERAPY
(2021)
Article
Health Care Sciences & Services
Staci S. Reynolds, Patricia Woltz, Edward Keating, Janice Neff, Jennifer Elliott, Daniel Hatch, Qing Yang, Bradi B. Granger
Summary: This study successfully improved compliance with CHG bathing process and nursing staff's knowledge and perceptions of CHG bathing through a tailored implementation program. Although compliance with CHG bathing documentation and CLABSI rates did not significantly improve, there was a clinically significant decrease in CLABSI rates.
IMPLEMENTATION SCIENCE
(2021)
Article
Medicine, General & Internal
Angela Dramowski, Sheylyn Pillay, Adrie Bekker, Ilhaam Abrahams, Mark F. Cotton, Susan E. Cof, Andrew C. Whitelaw
Summary: The study found that chlorhexidine gluconate (CHG) body washes significantly reduced bacterial colonization density in preterm neonates, but colonization levels rebounded rapidly post-intervention. The use of emollient improved skin condition but was associated with higher rates of Staphylococcus aureus colonization.
Article
Oncology
Danielle M. Zerr, Aaron M. Milstone, Christopher C. Dvorak, Amanda L. Adler, Lu Chen, Doojduen Villaluna, Ha Dang, Xuan Qin, Amin Addetia, Lolie C. Yu, Mary Conway Keller, Adam J. Esbenshade, Keith J. August, Brian T. Fisher, Lillian Sung
Summary: The study found that daily bathing with CHG-impregnated cloths did not reduce CLABSI in pediatric oncology patients and those undergoing HCT. There was a higher rate of CLABSI in the CHG group compared to the control group, while the rates of total positive blood cultures and acquisition of resistant organisms did not differ significantly between the two groups.
Article
Pediatrics
Hakan Kucuker, Salih Cagri Cakir, Nilgun Koksal, Hilal Ozkan, Fatma Kocael, Bayram Ali Dorum, Cansu Sivrikaya Yildirim, Solmaz Celebi, Mustafa Hacimustafaoglu
Summary: This study compares the use of povidone-iodine (PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions as disinfectants in neonatal intensive care units, and concludes that CHG-IA solution is superior for neonatal use.
PEDIATRICS INTERNATIONAL
(2023)
Article
Infectious Diseases
Abdullah Tarik Aslan, Alexis Tabah, Bahadir Koylu, Ayse Kaya Kalem, Firdevs Aksoy, Cigdem Erol, Ridvan Karaali, Burcu Tunay, Seda Guzeldag, Ayse Batirel, Emine Kubra Dindar, Ozlem Akdogan, Yeliz Bilir, Gulden Ersoz, Barcin Ozturk, Mehtap Selcuk, Mesut Yilmaz, Ahmet Akyol, Turkay Akbas, Hulya Sungurtekin, Arif Timuroglu, Yunus Gurbuz, Onur Colak, Yasar Bayindir, Ahmet Eroglu, Leyla Ferlicolak, Utku Cesme, Osman Dag, Niccolo Buetti, Francois Barbier, Stephane Ruckly, Quentin Staiquly, Jean-Francois Timsit, Murat Akova
Summary: The study aimed to uncover the clinical epidemiology, microbiological characteristics, and outcome determinants of hospital-acquired bloodstream infections (HA-BSIs) in Turkish ICU patients. The most frequent sources of HA-BSIs were intravascular catheter and lower respiratory tract, and there was a high rate of antibiotic resistance. Factors such as SOFA score, carbapenem resistance, previous myocardial infarction, COVID-19 diagnosis, and source control were associated with mortality in Gram-negative HA-BSIs.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Letter
Critical Care Medicine
Stijn Blot, Mieke Deschepper, Sonia Labeau
INTENSIVE CARE MEDICINE
(2022)
Review
Critical Care Medicine
Matthieu Boisson, Adrien Bougle, Candela Sole-Lleonart, Jayesh Dhanani, Kostoula Arvaniti, Jordi Rello, Jean-Jacques Rouby, Olivier Mimoz
Summary: The emergence of multidrug-resistant and extensive drug-resistant gram-negative bacteria globally has posed an increased risk of treatment failure for healthcare- or ventilator-associated pneumonia. Nebulization of antibiotics, specifically aminoglycosides and colistin methanesulfonate, offers a promising solution to optimize the treatment of these infections by providing high concentrations of antibiotics in the lungs while minimizing systemic exposure. Further research is needed to determine the optimal dosing regimen for nebulized antibiotics, but studies have shown their preventive and therapeutic potential in reducing the incidence of pneumonia. Nebulized colistin methanesulfonate appears to be more effective and safer than intravenous administration in treating ventilator-associated tracheobronchitis and pneumonia caused by multidrug-resistant and extensive drug-resistant gram-negative bacteria. It is recommended to monitor plasma trough concentrations when nebulizing aminoglycosides due to their systemic diffusion. Urgent large randomized controlled trials are needed to compare the efficacy of high-dose nebulized colistin methanesulfonate with high-dose intravenous colistin methanesulfonate or intravenous new beta-lactams in treating pneumonia caused by multidrug-resistant and extensive drug-resistant gram-negative bacteria.
SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Immunology
Joachim Klein, Jordi Rello, George Dimopoulos, Pierre Bulpa, Koen Blot, Dirk Vogelaers, Stijn Blot
Summary: Solid-organ transplantation (SOT) is a well-known risk factor for invasive pulmonary aspergillosis (IPA) in ICU patients. The study revealed that IPA in SOT patients in the ICU often presents with nonspecific medical imaging findings, leading to a high mortality rate of 68%. Lung transplantation was associated with better survival outcomes.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Letter
Critical Care Medicine
Stijn Blot, Elena Conoscenti
AUSTRALIAN CRITICAL CARE
(2023)
Letter
Critical Care Medicine
Ruben Houthoofdt, Zara Cuvelier, Brecht Serraes, Carl Haentjens, Nicolas Mpotos, Stijn Blot
AUSTRALIAN CRITICAL CARE
(2023)
Review
Critical Care Medicine
Ruth Endacott, Stijn Blot
Summary: This review summarizes the impact of the COVID-19 pandemic on intensive care nurses, including nursing workload, nurse staffing organization, experiences of redeployed staff, perception of patient care safety and quality, as well as staff health. It also highlights the worse mental health outcomes for nurses compared to other healthcare workers in intensive care. The review suggests the need for interventions to improve nurses' experiences and further studies to understand the long-term effects of the pandemic.
CURRENT OPINION IN CRITICAL CARE
(2022)
Editorial Material
Critical Care Medicine
Fiona Coyer, Sonia Labeau, Stijn Blot
INTENSIVE CARE MEDICINE
(2022)
Article
Critical Care Medicine
Gennaro De Pascale, Massimo Antonelli, Mieke Deschepper, Kostoula Arvaniti, Koen Blot, Ben Creagh Brown, Dylan de Lange, Jan De Waele, Yalim Dikmen, George Dimopoulos, Christian Eckmann, Guy Francois, Massimo Girardis, Despoina Koulenti, Sonia Labeau, Jeffrey Lipman, Fernando Lipovetsky, Emilio Maseda, Philippe Montravers, Adam Mikstacki, Jose-Artur Paiva, Cecilia Pereyra, Jordi Rello, Jean-Francois Timsit, Dirk Vogelaers, Stijn Blot
Summary: The study found that urgent and successful source control is associated with improved odds of survival in patients with secondary peritonitis. Source control is more determinative for outcome compared to empirical antimicrobial treatment.
INTENSIVE CARE MEDICINE
(2022)
Letter
Critical Care Medicine
S. Blot, M. Deschepper
MEDICINA INTENSIVA
(2023)
Editorial Material
Nursing
Karel E. Y. Claes, Ignace De Decker, Stijn Blot
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Review
Infectious Diseases
Marios Karvouniaris, Maria Panagiota Almyroudi, Mohd Hafiz Abdul-Aziz, Stijn Blot, Elisabeth Paramythiotou, Evdoxia Tsigou, Despoina Koulenti
Summary: Gram-negative bacterial resistance to antimicrobials has been increasing globally in recent decades, posing a daily challenge for hospital practice. Researchers and industry have made efforts to develop novel antimicrobials resilient to bacterial resistance mechanisms. Several new antimicrobials, including cefiderocol, imipenem-cilastatin-relebactam, eravacycline, omadacycline, and plazomicin, have become commercially available in the past five years. Other agents, such as aztreonam-avibactam, cefepime-enmetazobactam, cefepime-taniborbactam, cefepime-zidebactam, sulopenem, tebipenem, and benapenem, are in advanced development and have reached phase 3 clinical trials. This review critically discusses the characteristics, pharmacokinetic/pharmacodynamic properties, and current clinical data of these antimicrobials.
Article
Nursing
Elsa Afonso, Koenraad Smets, Mieke Deschepper, Evelien Verstraete, Stijn Blot
Summary: This study aimed to investigate the effect of late-onset sepsis on mortality in hospitalized neonatal patients of different gestational ages. The results showed that late-onset sepsis is an independent risk factor for mortality in very preterm and late preterm neonates.
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Editorial Material
Nursing
Zeynep Ture, Stijn Blot, Emine Alp
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Editorial Material
Nursing
Stijn Blot, Jean-Francois Timsit, Jean-Ralph Zahar
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Review
Microbiology
Georgios Papathanakos, Ioannis Andrianopoulos, Menelaos Xenikakis, Athanasios Papathanasiou, Despoina Koulenti, Stijn Blot, Vasilios Koulouras
Summary: Sepsis, a life-threatening infection-induced disorder of organ function, is a major cause of mortality worldwide, particularly in intensive care units. With an incomplete understanding of its complex pathophysiology, sepsis exhibits great heterogeneity in clinical expression, patient response to treatment, and outcomes. This heterogeneity poses a significant challenge for improving treatment in critical care. However, artificial intelligence and machine learning techniques offer promise for identifying clinical phenotypes and distinguishing individuals based on various factors such as temperature, hemodynamics, organ dysfunction, fluid status, ICU trajectories, and outcome. Ultimately, this approach may allow for targeted therapeutic interventions and optimal timing in septic patients.