UH3 Project: Active Bathing to Eliminate (ABATE) Infection

UH3 Project: Active Bathing to Eliminate (ABATE) Infection

Principal Investigator: Susan Huang, MD, MPH

Sponsoring Institution: University of California, Irvine

Collaborators:

  • Hospital Corporation of America

  • Harvard Medical School/Harvard Pilgrim Health Care

  • University of California, Irvine, School of Medicine

  • Rush University

  • John H. Stroger Hospital

  • Centers for Disease Control and Prevention

NIH Institute Providing Oversight: National Institute of Allergy and Infectious Diseases (NIAID)

Program Official: Clayton Huntley (NIAID)

Project Scientist: Gregory Deye (NIAID)

ClinicalTrials.gov Identifier: NCT02063867

Study Locations: 52 locations across the United States

Trial Status: Completed

Healthcare-associated infections (HAIs) are one of the most frequent causes of death in the United States and incur more than $6.5 billion in annual healthcare costs. Prevention of HAIs is a national priority for patient safety and best practice to reduce morbidity, mortality, and cost. Most infections are caused by common bacteria that normally live on the skin or in the nose and which overcome the body's normal defenses because of invasive medical devices, surgical incisions, or the physiologic effects of hospitalization.

Studies in intensive care units (ICUs) indicate that decolonization of patients' skin with chlorhexidine and nares with mupirocin can prevent many HAIs. However, evidence is lacking about the effectiveness of decolonization in non-ICU settings, where the majority of HAIs occur, and where medical care, risk of infection, patient-to-patient interactions, pathogen transmission, and bathing practices differ considerably from ICU settings. Decolonization is thus rarely used in these settings, despite its potential to meaningfully decrease the HAI rate.

ABATE Infection is a cluster-randomized controlled trial of hospitals that compares 2 quality improvement strategies to reduce multidrug-resistant organisms and HAIs in non–ICUs:

  • Arm 1: Usual care—Routine policy for showering or bathing non–critical care patients

  • Arm 2: Decolonization—Use of chlorhexidine as routine soap for showering or bed bathing for all non–critical care patients

NIH Project Information

Presentation

5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)

Publications

Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial. Lancet. 2019;393(10177):1205-1215.

Calculating power by bootstrap, with an application to cluster-randomized trials. EGEMS (Wash DC). 2017;4(1):1202.

Presentations

5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)

5/14/2018: Presentation to NIH Collaboratory Steering Committee (slides)

11/3/2017: PCT Grand Rounds: "The ABATE Infection Trial" (slides)

5/23/2017: Presentation on Top Barriers/Challenges and Recent Generalizable Lessons Learned to NIH Collaboratory Steering Committee (slides)

5/13/2016: PCT Grand Rounds: "The ABATE Infection Trial: Backstage Tour" (video; slides)

5/9/2016: Presentation on Data Governance and Data Sharing to NIH Collaboratory Steering Committee (slides)

5/9/2016: Presentation on Generalizable Lessons Learned to NIH Collaboratory Steering Committee (slides)

4/21/2015: Presentation to NIH Collaboratory Steering Committee (slides)

10/24/2014: PCT Grand Rounds (video; slides)

2/25/2014: Presentation on Lessons Learned to NIH Collaboratory Steering Committee (slides)

2/24/2014: Presentation on Data Sharing to NIH Collaboratory Steering Committee (slides)

1/24/2014: PCT Grand Rounds: "Survey to Assess Ethical Frameworks of Minimal Risk Studies" (video; slides)

10/18/2013: PCT Grand Rounds: "ABATE Project—an Update" (slides)

8/16/2013: PCT Grand Rounds: "The REDUCE MRSA Trial" (video; slides)

3/08/2013: PCT Grand Rounds: "Active Bathing to Eliminate Infection (ABATE Infection) Project" (video; slides)

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Citation:

Demonstration Projects: UH3 Project: Active Bathing to Eliminate (ABATE) Infection. In: Rethinking Clinical Trials: A Living Textbook of Pragmatic Clinical Trials. Bethesda, MD: NIH Health Care Systems Research Collaboratory. Available at: https://rethinkingclinicaltrials.org/demonstration-projects/uh3-project-active-bathing-to-eliminate-abate-infection/. Updated March 27, 2020.