Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath on MRSA Nosocomial Bacteremia and CLABSI in Critically Ill Patients

Abstract

Abstract Background: Nosocomial MRSA bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% Povidone twice daily to both nares in addition to Chlorhexidine bathing on nosocomial MRSA bacteremia in critically ill patients. Method: Quality improvement Study was done with pre- and post-design. The study period is from January 2018 until February 2020, February 2021, and May 2021. The control period (From January 2018 to May 2019) consisted of CHG bathing alone, and in the intervention period, we added 10% Povidone-iodine to the nares of critically ill patients. We analyzed Rates of nosocomial MRSA bacteremia and CLABSI and potential cost savings. Results: There were no significant differences in rates of MRSA bacteremia in critically ill patients. Nosocomial MRSA bacteremia was significantly lower during the intervention period in Medical/surgical areas (MSA). CLABSI was significantly lower during the intervention period in critically ill patients. There was no Staphylococcus aureus CLABSI in CCA during the intervention period. The intervention also resulted in significant cost savings. Conclusion: Applying 10% Povidone-iodine twice a day in addition to CHG bathing resulted in a significant decrease in CLABSI in Critically ill patients and a reduction in nosocomial MRSA in the non-intervention areas. The COVID-19 pandemic confounds the results of our study. Further trials are needed to tease out individual patients' benefit from the intervention.