Saturday, October 5, 2013

I hope I live long enough

Mike has had his say regarding universal gloves and gowns. I'm a huge fan of Mike's push for horizontal interventions like hand hygiene, but I was surprised when I read that he is pushing universal chlorhexidine bathing in his hospital. I will keep this post short so you can quickly move down to read his post, but I have a couple comments. First - chlorhexidine is an "antibiotic" and resistance already exists.  Second, if there is one thing we know about overuse (i.e. universal use) of antibiotics is that it leads to resistance. Third, I know that CHG is fashionable (like antibiotic cycling once was) and you can't fight fashion. Finally, if we really want clean hands, when you add the BUGG study's gloving+hand-hygiene compliance this would equal ~95% hand cleanliness.

In the meantime, I will sit on the sidelines and wait for CHG resistance to rise and the many MDR-acinetobacter and other GNR outbreaks that will occur secondary to it's overuse. Despite the title of my post, I suspect I won't have to wait too long.

Addendum: looking through the twitter chatter after the BUGG study was released, I noticed a disturbing trend of HCW complaining more about the burden of wearing contact precautions than the burden of HAI.

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