Objective

To investigate the effect of daily whole-body bathing (WBB) using disposable washcloth wipes/caps impregnated with an antiseptic solution containing the quaternary ammonium base compound didecyl dimethyl ammonium chloride (DDAC).

Methods

A prospective double-blind randomized crossover trial was conducted to compare WBB of adult intensive care unit (ICU) patients with washcloth wipes/caps impregnated with either regular cleanser/shampoo or the antiseptic DDAC. The clinical trial was performed in a medical ICU (MICU) and a surgical ICU (SICU). The study period was divided into two 6-month intervals with alternating treatment regimens.

Results

A total of 1540 ICU patients (total length of ICU stay 10 470 days) were included in the trial. Compared to controls, DDAC bathing was found to be associated with reduced incidence rates per 1000 patient days for central-venous-line-associated infections (CLAIs) caused by Gram-positive bacteria (GPB) from 16.39 (95%CI 13.1–20.3) in the control group to 7.28 (95%CI 5.2–9.9) in the intervention group (p 0.01). A stratified analysis by unit showed that the incidence rates of CLAI due to GPB were reduced by the intervention in both the MICU and the SICU from 21.2 (95%CI 15.8–27.7) to 9.3 (95%CI 5.8–14.1) (p < 0.01) and from 12.1 (95%CI 8.3–17.0) to 5.7 (95%CI 3.4–9.1) (p 0.01), respectively. There was a trend towards reduction in catheter-related bloodstream infections (CRBSIs) and bloodstream infections (BSIs); however, this did not reach statistical significance due to carry-over effects and small numbers.

Conclusions

Given the growing need for new concepts to prevent and control healthcare-associated infections, DDAC may be a new and promising agent for WBB of ICU patients.

中文翻译：

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二癸基二甲基氯化铵浸渍毛巾擦拭全身沐浴对成人重症监护病房导管相关血流感染和中心静脉导管相关感染的影响

客观的

使用浸有含有季铵碱化合物二癸基二甲基氯化铵 (DDAC) 的防腐剂溶液的一次性毛巾擦拭巾/帽子，研究每日全身沐浴 (WBB) 的效果。

方法

进行了一项前瞻性双盲随机交叉试验，以比较成人重症监护病房 (ICU) 患者的 WBB 与浸有普通清洁剂/洗发水或防腐剂 DDAC 的毛巾湿巾/帽子。临床试验在医疗重症监护室（MICU）和外科重症监护室（SICU）进行。研究期分为两个 6 个月的间隔，采用交替治疗方案。

结果

试验共纳入 1540 名 ICU 患者（ICU 住院总时间为 10 470 天）。与对照组相比，DDAC 沐浴被发现与每 1000 患者日由革兰氏阳性菌 (GPB) 引起的中心静脉线相关感染 (CLAI) 的发病率降低相关，从 16.39 (95%CI 13.1–20.3)对照组为 7.28 (95%CI 5.2–9.9)，干预组为 7.28 (p < 0.01)。按单位进行的分层分析表明，由于 GPB 引起的 CLAI 的发生率通过对 MICU 和 SICU 的干预从 21.2（95%CI 15.8-27.7）降低到 9.3（95%CI 5.8-14.1）（p < 0.01) 和从 12.1 (95%CI 8.3–17.0) 到 5.7 (95%CI 3.4–9.1) (p = 0.01)。导管相关血流感染 (CRBSI) 和血流感染 (BSI) 有减少的趋势；然而，

结论

鉴于对预防和控制医疗相关感染的新概念的需求不断增长，DDAC 可能是 ICU 患者 WBB 的一种新的且有希望的药物。