Using wash cloths in jails shows promise for reducing costly infections

New research shows providing detainees wash cloths treated with a skin cleanser could reduce the prevalence of Staphylococcus aureus (S. aureus) bacteria in U.S. jails. Researchers looked at the effect on transmission of S. aureus of using wash cloths treated with chlorhexidine gluconate (CHG) compared with wash cloths with only plain water in detainees at Dallas County Jail. The study was published in the December issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

"Detainees in U.S. jails are at high risk for skin infections caused by methicillin resistant S. aureus (MRSA) and methicillin-susceptible S. aureus. While the use of CHG has been well studied in the healthcare setting, there has been limited research for it in this high-risk population," Michael David, MD, PhD, a lead author of the study. "Our findings suggest a promising and inexpensive intervention that may decrease S. aureus colonization in this high-risk group."

Community-associated MRSA is the leading cause of skin and soft tissue infections in U.S. jails. Asymptomatic MRSA carriage is a risk factor for infection and detainees possess a high prevalence of nasal colonization, which can be spread from person-to-person by direct contact or via contaminated inanimate objects. These infections also take a significant financial toll in terms of healthcare costs because MRSA infections are expensive to treat and are often recurrent.

Researchers conducted a randomized, controlled trial with 4,196 detainees in 68 detention divisions in the Dallas County Jail. Divisions were randomly assigned to be in one of three clusters: those who received disposable wash cloths that contained the skin cleanser CHG to clean their entire skin surface three times per week, those who received identical wash cloths containing only water, and the last group received no specific skin cleansing treatment.

Within six months, the CHG and plain water wash cloths did not significantly decrease the presence of MRSA. However, after six months, carriage of any S. aureus was 51.1 percent in the group with no intervention, 40.7 percent in the group using CHG wash cloths and 42.8 percent in the group using water wash cloths.

The CHG wash cloths were responsible for a significant decrease in S. aureus hand and/or nose carriage, but plain water wash cloths were almost as effective as CHG washcloths at decreasing carriage of S. aureus.