Evidence map›Paper›PMID 23388005›Full record

Trial reportThe New England journal of medicine2013

Effect of daily chlorhexidine bathing on hospital-acquired infection.

Michael W Climo, Deborah S Yokoe, David K Warren, Trish M Perl, Maureen Bolon, Loreen A Herwaldt, Robert A Weinstein, Kent A Sepkowitz, John A Jernigan, Kakotan Sanogo and 1 more

Erratum issued 3 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 198 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
198citing papers in PubMed, 11 pooled it
50.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00502476 unknown statusnot on this map

Multicenter Evaluation of The Effectiveness of Source Control With Daily Chlorhexidine Skin Preparation in Reducing Nosocomial Infections Including MRSA and VRE

TypeobservationalSponsorHunter Holmes Mcguire Veteran Affairs Medical CenterRan2007 to 2009Enrolled14,000ConditionsNosocomial Bacteremia, MRSA Colonization, MRSA Infection, VRE ColonizationArmsBathing with Chlorhexidine Impregnated Washcloths
NCT02490631 phase3completednot on this mapstarted 2015, after this paper: background citation

A Randomized Controlled Trial of 2% Chlorhexidine Gluconate Skin Preparation Cloths for the Prevention of Post op Surgical Site Infections in Spine Patients (Decrease SSI or DeSSI)

TypeinterventionalSponsorVanderbilt UniversityRan2015 to 2018Enrolled158ConditionsSurgical Site Infections, Post Operative ComplicationArms2% chlorhexidine gluconate cloths
NCT07039955 naenrolling by invitationnot on this mapstarted 2025, after this paper: background citation

Effectiveness of Daily Chlorhexidine Bathing and Antibiotic and Proton Pump Inhibitor (PPI) Stewardship in Preventing Transmission and Infection Caused by Carbapenemase-Producing Enterobacteriaceae (CPE)

TypeinterventionalSponsorChuncheon Sacred Heart HospitalRan2025 to 2026Enrolled5,760ConditionsCarbapenemase-Producing Enterobacteriaceae (CPE), Healthcare-Associated Infections (HAIs)ArmsDaily Chlorhexidine Bathing, Antimicrobial and PPI Stewardship Program, Standard Bathing
3 · Its place in the literature

Who cites it

198 citing papers in PubMed, 11 syntheses or guidelines pooled it, 644 citations in OpenAlex.

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  9. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016
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138 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 3 countries.

Michael W ClimoHunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA 23249, USA. michael.climo@va.gov
Deborah S Yokoe
David K Warren
Trish M Perl
Maureen Bolon
Loreen A Herwaldt
Robert A Weinstein
Kent A Sepkowitz
John A Jernigan
Kakotan Sanogo
Edward S Wong
Virginia Commonwealth University Medical Center · USCenters for Disease Control and Prevention · UGCook County Health and Hospitals System · USHarvard University · USJohns Hopkins University · USMemorial Sloan Kettering Cancer Center · USNorthwestern University · PHWashington University in St. Louis · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Multicenter Trial of Daily Chlorhexidine Bathing to Reduce Nosocomial InfectionsU01CI000395 · CI · RICHMOND INSTITUTE FOR VETERANS RESEARCH · PI CLIMO, MICHAEL WILLIAM · 2006 to 2007
$535k
NCI NIH HHS P30 CA008748NCPDCID CDC HHS U01 CI000395PHS HHS 5U01C1000395-02
6 · The paper itself

Abstract

backgroundResults of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs).

methodsWe conducted a multicenter, cluster-randomized, nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections. Nine intensive care and bone marrow transplantation units in six hospitals were randomly assigned to bathe patients either with no-rinse 2% chlorhexidine-impregnated washcloths or with nonantimicrobial washcloths for a 6-month period, exchanged for the alternate product during the subsequent 6 months. The incidence rates of acquisition of MDROs and the rates of hospital-acquired bloodstream infections were compared between the two periods by means of Poisson regression analysis.

resultsA total of 7727 patients were enrolled during the study. The overall rate of MDRO acquisition was 5.10 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.03), the equivalent of a 23% lower rate with chlorhexidine bathing. The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.007), a 28% lower rate with chlorhexidine-impregnated washcloths. No serious skin reactions were noted during either study period.

conclusionsDaily bathing with chlorhexidine-impregnated washcloths significantly reduced the risks of acquisition of MDROs and development of hospital-acquired bloodstream infections. (Funded by the Centers for Disease Control and Prevention and Sage Products; ClinicalTrials.gov number, NCT00502476.).

Indexed as

BathsDrug Resistance, Multiple, BacterialAnti-Infective Agents, LocalBacteremiaChlorhexidineCross InfectionCross-Over StudiesEnterococcusGram-Positive Bacterial InfectionsHumansIncidenceIntensive Care UnitsKaplan-Meier EstimateMethicillin-Resistant Staphylococcus aureusProportional Hazards ModelsStaphylococcal InfectionsAnti-Infective Agents, LocalChlorhexidine

Identifiers

PMID23388005
PMCPMC5703051
OpenAlexW2218892404

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.