The ICUs were not randomised to the intervention, but it’s a pretty good sample size so you’d expect any variability to be smoothed out naturally. However, it is worth nothing that 88% of the hospitals that implemented CHG bathing also had an active MRSA screening programme, whereas only 50% of the hospitals that did not implement CHG bathing had an MRSA screening programme. Thus, implementing CHG could be a marker of a more complete infection prevention and control programme, which could confound these findings. Perhaps related to this is the finding that MRSA, VRE, CAUTI, CLABSI, all primary BSI and VAP were all more common in the ICUs that implemented CHG, suggesting that the baseline characteristics of the units that chosen to implement CHG were different to those that did not.
Nonetheless, the results from the time series analysis (which evaluated whether there were changes in the rate of these HCAI-related outcomes) are impressive: CLABSIs were reduced by 59%, primary BSIs by 36%, and VRE CLABSIs by 33% on the units that were using CHG daily bathing. There were no changes in the rate of MRSA-related HCAI metrics.
This study performed in a large number of community hospitals (rather than large academic teaching hospitals) provides real-world data that CHG bathing reduces the rate of important HCAIs. However, it also illustrates that CHG bathing is not a silver bullet and needs for form part of a multifaceted strategy to prevent HCAI on ICUs.
The Zika virus was first identified in Africa in the 1940s but has recently hit the headlines due to a sharp apparent increase in prevalence in some parts of the world, and a potential link with microcephaly. The Zika virus is transmitted mainly through mosquito bites, but could there be any infection prevention and control implications? The short answer is no: human-to-human transmission of the Zika virus appears to be rare, although a small number of reports of sexual transmission, horizontal transmission (from mother to baby), and transmission via blood transfusions have been reported.
So, it seems that the steps required to prevent the transmission of Zika are similar to those required for malaria. Preventing being bitten by a mosquito in high prevalence areas is the key to prevention. What is not known is what is driving the recent increase in prevalence. But we will watch the emerging story carefully to ensure no other infection prevention and control challenges emerge.
Click on this link to show an interesting and insightful infographic about the Zika Virus: http://www.mphonline.org/zika-virus/