Die DGHM prämiert Veröffentlichungen, die sich durch eine große Anwendungsrelevanz auszeichnen. Für diese Auszeichnung können Publikationen vorgschlagen werden, an denen ein DGHM-Mitglied als Erst- oder LetztautorIn beteiligt ist und die in den vorangegangenen 3 Monaten hochrangig publiziert wurden.
Aktuelles Highlight der Infektionsprävention und Klin. Mikrobiologie
EFFECT of daily antiseptic bathing with octenidine on ICU-acquired bacteremia and ICU-acquired multidrug-resistant organisms: a multicenter, cluster-randomized, double-blind, placebocontrolled, cross-over study
Tiffany Schaumburg # 1 ,Norbert Köhler # 2 , Yasmine Breitenstein 2 , Susanne Kolbe-Busch3 , Dirk Hasenclever # ,4 , Iris F Chaberny #, 3, 5
Intensive Care Medicine, DOI: 10.1007/s00134-024-07667-2
Tiffany Schaumburg
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/39417875/
Abstract:
Purpose: Antiseptic bathing has garnered attention in an effort to reduce hospital-acquired infections. Previous studies have shown the efficacy of antiseptic bathing in high-risk environments, such as intensive care units (ICUs), using chlorhexidine. In this study we aimed to evaluate the effectiveness of octenidine as a potential alternative due to its established popularity and widespread use in Europe.
Methods: We compared the rates of ICU-acquired primary bacteremia and ICU-acquired multidrug-resistant organisms (MDROs) in a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study using octenidine-impregnated and placebo washcloths. On 44 ICUs in 23 hospitals throughout Germany, we compared individual ICUs with themselves over two 12-month time periods. All data were obtained digitally via hospital information systems as individual ward-movement data and microbiological test results; both endpoints were algorithmically derived.
Results: 104,039 ICU episodes from 93,438 patients with 712,784 microbiological test results were analyzed, thereby detecting 1508 cases of ICU-acquired primary bacteremia and 1871 cases of ICU-acquired MDRO. Bathing with octenidine-impregnated washcloths prevented ICU-acquired primary bacteremia; a risk reduction of 17% was seen homogeneously across all participating ICUs (adjusted hazard ratio (HR) 0.83, 95% confidence interval (CI) [0.75; 0.92], p = 0.0003). This reduction affected predominantly coagulase-negative staphylococci (53%) and enterococci (17%). However, no intervention effect was seen for ICU-acquired MDROs (adjusted HR 0.98, 95% CI [0.83; 1.15]). Heterogeneity among intra-ICU intervention effects on MDRO acquisition was substantial.
Conclusions: Antiseptic bathing with octenidine may be effective in preventing ICU-acquired primary bacteremia, particularly due to Gram-positive bacteria and common skin commensals.
Keywords: Antiseptic bathing; Bacteremia; Intensive care unit; Multidrug-resistant organisms; Octenidine.
Kommentar:
Dies ist das erste Mal, dass gezeigt wurde, dass in der Krankenhaushygiene mit einer DFG-geförderten Klinischen Studie aus der direkten unmittelbaren Patientenversorgung heraus der EFFEKT der täglichen Waschung von Patienten mit Octenidin-getränkten Waschhandschuhen auf Krankenhausinfektionen in Intensivstationen per randomisierter, doppelt-verblindeter Cross-Over Studie infektionspräventive Maßnahmen unabhängig getestet und ausgewertet werden konnte mit dem Ergebnis, dass antiseptische Waschungen mit Octenidin primäre Bakteriämien verhindern können.
Kontakt:
Tiffany Schaumburg
Universitätsklinikum Leipzig
Institut für Hygiene, Krankenhaushygiene und Umweltmedizin
Liebigstr. 22, Haus 7
04103 Leipzig
E-Mail: tiffany.schaumburg@medizin.uni-leipzig.de
Autor:inneninformationen:
1 University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany. tiffany.schaumburg@medizin.uni-leipzig.de.
2 Leipzig University, Faculty of Medicine, Clinical Trial Centre (ZKS Leipzig), Leipzig, Germany.
3 University of Leipzig Medical Center, Institute of Hygiene, Hospital Epidemiology and Environmental Health, Leipzig, Germany.
4 Leipzig University, Faculty of Medicine, Institute of Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig, Germany.
5 Kiel University, University Hospital Schleswig-Holstein, Institute of Hospital Epidemiology and Environmental Hygiene, Kiel, Germany.
# Contributed equally.
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