{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:04:06Z","timestamp":1787965446249,"version":"build-2784847793"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24000813_as1\"><jats:title>Objective:<\/jats:title><jats:p>To characterize the relationship between chlorhexidine gluconate (CHG) skin concentration and skin microbial colonization.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000813_as2\"><jats:title>Design:<\/jats:title><jats:p>Serial cross-sectional study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000813_as3\"><jats:title>Setting\/participants:<\/jats:title><jats:p>Adult patients in medical intensive care units (ICUs) from 7 hospitals; from 1 hospital, additional patients colonized with carbapenemase-producing Enterobacterales (CPE) from both ICU and non-ICU settings. All hospitals performed routine CHG bathing in the ICU.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000813_as4\"><jats:title>Methods:<\/jats:title><jats:p>Skin swab samples were collected from adjacent areas of the neck, axilla, and inguinal region for microbial culture and CHG skin concentration measurement using a semiquantitative colorimetric assay. We used linear mixed effects multilevel models to analyze the relationship between CHG concentration and microbial detection. We explored threshold effects using additional models.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000813_as5\"><jats:title>Results:<\/jats:title><jats:p>We collected samples from 736 of 759 (97%) eligible ICU patients and 68 patients colonized with CPE. On skin, gram-positive bacteria were cultured most frequently (93% of patients), followed by <jats:italic>Candida<\/jats:italic> species (26%) and gram-negative bacteria (20%). The adjusted odds of microbial recovery for every twofold increase in CHG skin concentration were 0.84 (95% CI, 0.80\u20130.87; <jats:italic>P<\/jats:italic> &lt; .001) for gram-positive bacteria, 0.93 (95% CI, 0.89\u20130.98; <jats:italic>P<\/jats:italic> = .008) for <jats:italic>Candida<\/jats:italic> species, 0.96 (95% CI, 0.91\u20131.02; <jats:italic>P<\/jats:italic> = .17) for gram-negative bacteria, and 0.94 (95% CI, 0.84\u20131.06; <jats:italic>P<\/jats:italic> = .33) for CPE. A threshold CHG skin concentration for reduced microbial detection was not observed.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000813_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>On a cross-sectional basis, higher CHG skin concentrations were associated with less detection of gram-positive bacteria and <jats:italic>Candida<\/jats:italic> species on the skin, but not gram-negative bacteria, including CPE. For infection prevention, targeting higher CHG skin concentrations may improve control of certain pathogens.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.81","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T07:37:38Z","timestamp":1716881858000},"page":"1079-1084","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Relationship between chlorhexidine gluconate concentration and microbial colonization of patients\u2019 skin"],"prefix":"10.1017","volume":"45","author":[{"given":"Yoona","family":"Rhee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4676-5653","authenticated-orcid":false,"given":"Andrew T.","family":"Simms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3066-708X","authenticated-orcid":false,"given":"Michael","family":"Schoeny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0914-0291","authenticated-orcid":false,"given":"Arthur W.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6724-5841","authenticated-orcid":false,"given":"Meghan A.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1932-7540","authenticated-orcid":false,"given":"Shruti","family":"Gohil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-4245","authenticated-orcid":false,"given":"Chanu","family":"Rhee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naasha J.","family":"Talati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Warren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Welbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1903-756X","authenticated-orcid":false,"given":"Karen","family":"Lolans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela B.","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary K.","family":"Hayden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the CDC Prevention Epicenters Program","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"key":"S0899823X24000813_ref3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.3.306"},{"key":"S0899823X24000813_ref5","doi-asserted-by":"publisher","DOI":"10.1086\/667371"},{"key":"S0899823X24000813_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.124"},{"key":"S0899823X24000813_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.265"},{"key":"S0899823X24000813_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2017.312"},{"key":"S0899823X24000813_ref16","volume-title":"Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically","year":"2018"},{"key":"S0899823X24000813_ref17","volume-title":"Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 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