Nosocomial infections contribute significantly to the incidence and mortality of heart patients. One of the aspects of preventing their appearance is considered to be the decontamination of endogenous flora, including the nasopharynx and the oropharynx.

The aim of a prospective, randomized, double-blind, placebo-controlled study by P. Segers et al. (Netherlands) for the period from August 2003 to September 2005, was to determine the effect of perioperative decontamination of the nasopharynx and oropharynx of chlorhexidine gluconate on the incidence of nosocomial infections in patients undergoing cardiac surgery during the postoperative period. 954 patients over the age of 18, who were planning elective cardiac surgery, were washed their oropharynx with a 0.12% solution of chlorhexidine gluconate or a placebo and applied the ointment of this drug or placebo on the nasal mucosa. The main evaluation indicators were the incidence of nosocomial infection, the incidence of nasopharyngeal carriage Staphylococcus aureus and the length of hospital stay.

According to the results, the incidence of nosocomial infection in the group of patients treated with chlorhexidine gluconate was lower than in the placebo group (19.8% vs 26.2%, respectively ; absolute risk reduction (ATS) 6.4%; 95% confidence interval (CI) 1.1% -11.7%; p = 0.002). In particular, patients in this group developed lower respiratory tract infections and deep infections of the surgical area much less often than patients in the control group (TTY 6.5%; 95% CI 2.3% -10.7%; p = 0.002; vs 3.2%; 95% CI 0.9% -5.5%; p = 0.002, respectively). To prevent an episode of nosocomial infection, it was necessary to treat chlorhexidine with gluconate in 16 patients.

Treatment with the drug studied was also accompanied by a significant decrease in the frequency of detection of colonization of the nasal mucosa S. aureus (57.5% vs 18.1% in the placebo group, p less than 0.001) and the total length of stay in hospital (9.5 days vs 10.3 days in the placebo group; ATS 0 , 8 days; 95% CI 0.24-1.88; p = 0.04).

Decontamination of the nasopharynx and chlorhexidine oropharynx with gluconate is an effective method of reducing the incidence of nosocomial infections after heart surgery.