Abstract
Antiseptic bathing is widely implemented as part of horizontal infection prevention and control (IPC) intervention programmes. Routine antiseptic bathing of all patients has become common practice in some intensive care units (ICUs) [ 1 Frost S.A. Hou Y.C. Lombardo L. Metcalfe L. Lynch J.M. Hunt L. et al. Evidence for the effectiveness of chlorhexidine bathing and health care-associated infections among adult intensive care patients: a trial sequential meta-analysis. BMC Infect Dis. 2018; 18: 679 Crossref PubMed Scopus (21) Google Scholar , 2 Wenzel R.P. Edmond MB Infection control: the case for horizontal rather than vertical interventional programs. Int J Infect Dis. 2010; 14: S3-S5 Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar ]. There is evidence for its effectiveness to reduce healthcare-associated infections and multi-drug-resistant organisms [ [1] Frost S.A. Hou Y.C. Lombardo L. Metcalfe L. Lynch J.M. Hunt L. et al. Evidence for the effectiveness of chlorhexidine bathing and health care-associated infections among adult intensive care patients: a trial sequential meta-analysis. BMC Infect Dis. 2018; 18: 679 Crossref PubMed Scopus (21) Google Scholar ]. Protocols vary according to indication, antiseptic agent and pharmaceutical formulation, as does the amount of water required for each bathing. Some products are removed with water after a few minutes (rinse-off), and some after 1 week (leave-on). We share the enthusiasm for antiseptic bathing and this intervention was widely implemented in our hospitals. From our research group, Messler et al. demonstrated a significant reduction in vancomycin-resistant enterococcus infections after introduction of antiseptic rinse-off octenidine-based bathing in an ICU [ [3] Messler S. Klare I. Wappler F. Werner G. Ligges U. Sakka S.G. et al. Reduction of nosocomial bloodstream infections and nosocomial vancomycin-resistant Enterococcus faecium on an intensive care unit after introduction of antiseptic octenidine-based bathing. J Hosp Infect. 2019; 101: 264-271 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar ]. However, one must be aware of the collateral damage, such as antiseptic resistance [ [4] Htun H.L. Hon P.Y. Holden M.T.G. Ang B. Chow A. Chlorhexidine and octenidine use, carriage of qac genes, and reduced antiseptic susceptibility in methicillin-resistant Staphylococcus aureus isolates from a healthcare network. Clin Microbiol Infect. 2019; 25: 1154.e1-1154.e7 Abstract Full Text Full Text PDF Scopus (27) Google Scholar ], and consider unexpected effects, as shown in the following example.
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