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The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit



To assess the impact of chlorhexidine gluconate (CHG) bathing on skin bacterial burden in neonates.

Study design

In this prospective observational study, arm and groin skin bacterial growth was measured in 40 CHG-exposed and nonexposed neonates admitted to the NICU. Exposed neonates received 2% CHG baths per protocol for central line-associated bloodstream infection (CLABSI) prevention or Staphylococcus aureus decolonization.


Forty neonates were enrolled, 18 of whom were CHG-exposed. Mean baseline Gram-positive (GP) bacterial burden was 2.19 log CFU/ml on the arm and 1.81 log CFU/ml on the groin. Bacterial burden decreased after the first bath, but returned to baseline by 72 h. Residual skin CHG concentration declined over time, with a corresponding increase in GP bacterial burden.


CHG bathing reduces skin bacterial burden, but burden returns to baseline after 72 h. Twice weekly CHG bathing may be inadequate to suppress skin bacterial growth in hospitalized neonates.

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The authors wish to thank the study’s participants and their families, as well as Annie Voskertchian and Anne King for their study support, and Dr. Mary K. Hayden and her colleagues at Rush University for sharing their colorimetric assay protocol.


This study was supported by an investigator-initiated research grant from Sage Products, LLC, and NIH Training Grant Award T32 HL 125239-1 (JJ).

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Correspondence to Julia Johnson.

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Johnson, J., Suwantarat, N., Colantuoni, E. et al. The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. J Perinatol 39, 63–71 (2019).

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