Study | Bleasdale et al. [24] | Climo et al. [12] | Huang et al. [13] | Camus et al. [25] | Noto et al. [16] |
---|---|---|---|---|---|
Study design | Prospective, 2-arm, crossover | Multicenter, cluster-randomized, non-blinded crossover trial | Cluster-randomized trial | Multicenter, placebo-controlled, randomized, double-blind study | Multicenter, pragmatic cluster randomized, crossover, controlled study |
Location | Single center, USA | 7 hospitals, USA | 43 hospitals, USA | 3 hospitals, France | Single center, USA |
Study site | Two 11-bed medical ICUs | Eight ICUs, one BMT unit | 74 ICUs | Medical ICUs | 5 adult ICUs |
Study period | Jun 8 to Dec 20, 2005 and Jan 5 to Jun 21, 2006 | Aug 2007 to Feb 2009 | Apr 8, 2010 to Sep 30, 2011 | Apr 1996 to Jun 1999 | Jul 2012 to Jul 2013 |
Intervention | Daily bathing with 2 % chlorhexidine-impregnated cloth | Daily bathing with 2 % chlorhexidine-impregnated cloth | Daily bathing with 2 % chlorhexidine-impregnated cloth and twice-daily intranasal mupirocin | Daily bathing with 4 % chlorhexidine soap and daily intranasal mupirocin | Daily bathing with 2 % chlorhexidine-impregnated cloth |
Comparator | Daily bathing with soap and water | Daily bathing with non-antimicrobial washcloths | Screening and isolation for MRSA colonization | Daily bathing with non-antiseptic liquid soap | Daily bathing with disposable non-antimicrobial cloths |
Number of patients | |||||
Intervention | 391 | 3970 | 26,024 | 259 | 4852 |
Comparator | 445 | 3842 | 23,480 | 256 | 4488 |
Number of patient-days | |||||
Intervention | 2210 | 24,902 | 101,603 | 3963 | 20,720.5 |
Comparator | 2219 | 24,983 | 88,222 | 4276 | 19,201.5 |
Other HCAI prevention | The MICU catheter insertion policy | Contact precautions | Contact precaution policies, based on the Centers for Disease Control and Prevention | Standard precautions according to the French recommendation | Contact precautions according to the usual practice of each unit |
The period under observation | MICU stay | Between the control period and the intervention period | From the third day after ICU admission through the second day after ICU discharge | Between the randomization and the termination date of study treatments plus an additional 48 h | During the chlorhexidine bathing period |