Horizontal approaches to infection prevention: daily chlorhexidine gluconate bathing

Various infection control strategies are used to decrease the incidence of healthcare-associated infections (HAIs). For example, chlorhexidine gluconate (CHG), an antiseptic with a wide range of antimicrobial activity, has been proven through numerous studies to act as an infection prevention tool in intensive care units (Milstone et al, 2008; Septimus et al, 2104; Pallotto et al, 2019). CHG is a broad-spectrum cationic biguanide antiseptic which is effective against Gram-positive bacteria, Gram-negative bacteria, enveloped viruses (in vitro) and some fungi (McDonnell and Russell, 1999). CHG solutions are approved as antiseptic skin cleansers to reduce micro-organisms on the skin that may cause disease. They are not intended to treat or prevent any specific disease or infection as a standalone therapy, but may serve as part of a comprehensive infection prevention bundle. CHG reduces the density of micro-organisms on the skin by binding to the negatively charged bacterial cell walls, causing bacterial cell death (Donskey and Deshpande, 2016). Daily bathing with CHG, as part of a comprehensive infection prevention bundle, is a highly effective intervention for HAI prevention (Hopkins et al, 2006; Donskey and Deshpande, 2016; Huang et al, 2019). It is used throughout a patient's stay in a hospital, where a nurse or support worker will help clean an individual using a CHG skin cleanser and water, in the place of a soap bath. CHG bathing, implemented universally across the hospital offers a key tool to reduce the incidence of HAIs.