Abstract

To the Editor: The benefit of chlorhexidine bathing reported by Climo and colleagues (Feb. 7 issue)1 appears to be a reduction in the rate of bloodstream infections due to coagulase-negative staphylococci. As the authors note, the National Healthcare Safety Network (NHSN) definition of a central-catheter–associated bloodstream infection requires primarily a positive blood culture in patients with a central venous catheter in place within 48 hours before detection. As commensal organisms of the skin, coagulase-negative staphylococci are a common cause of false positive blood cultures. Is it possible that the reduction in hospital-acquired bloodstream infection reported in the study (Table 3 of the article) was the consequence of a chlorhexidine-precipitated decrease in skin colonization with coagulase-negative staphylococci (and candida) and thus a reduction in the number of false positive blood cultures in the patients bathed with the antimicrobial washcloths? The lack of a reduction in bloodstream infections due to Staphylococcus aureus or gram-negative bacilli (Table 3 of the article), neither of which are traditional skin colonizers, supports that possibility.

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