February 11, 2013
Nicholas Reich, Research Assistant Professor of Biostatistics, is the lead biostatistician for a team of researchers who recently reported results of one of the largest infection prevention trials ever conducted in children. Investigators at Johns Hopkins Children’s Center led the work at five pediatric hospitals. The team’s findings, that daily baths with an antiseptic soap can reduce the risk of bloodstream infection in critically ill hospitalized children, were reported in a recent issue of the prestigious journal, The Lancet.
Reich and colleagues collected data from more than 4,000 children hospitalized in 10 United States pediatric intensive care units over one year. They compared risk of bloodstream infections between children bathed with standard soap baths to those bathed with diluted chlorhexidine gluconate (CHG), a common compound that kills viruses, bacteria and fungi. Children bathed with the antiseptic solution had a 36-percent lower risk of infection compared to those washed with soap and water. A common complication among critically ill hospitalized patients, bloodstream infections can lead to organ damage and death.
The study design called for children in half of the 10 intensive care units to be bathed with washcloths soaked in CHG solution while the other half received soap-and-water sponge baths. Midway through the study, each unit changed bathing procedures so they were using the opposite bathing technique. As Reich explains, “One of the challenges with studies like this is ensuring that the children receiving one treatment are comparable with the other. The ‘crossover’ design that we used in this study ensures that these comparisons are as strong as possible. This, in turn, gives us more confidence in the conclusions that the antiseptic baths are an effective treatment.”
The researchers say this finding shows that the simple procedure often seen as offering nothing more than a comfort can be a powerful tool to prevent disease. Lead investigator Aaron Milstone of Johns Hopkins said, “Daily bedside baths with an antiseptic solution may be an easy, quick and relatively cheap way to cut the risk of a potentially life-threatening infection in these vulnerable children.”
Trish Perl, professor of medicine at Johns Hopkins and the senior epidemiologist for the Johns Hopkins Health System said, “Bloodstream infections, catheter-related or not, occur in many critically ill children and cause a lot of morbidity, so our efforts should be on reducing bacteremia of any and all origins. ”
The research was funded by Sage Products, Inc., with additional support from the National Institutes of Health.