Korean J Intern Med.  2016 Nov;31(6):1159-1170. 10.3904/kjim.2015.240.

The efficacy of daily chlorhexidine bathing for preventing healthcare-associated infections in adult intensive care units

• Huang HP
• Chen B
• Wang HY
• He M

• KMID: 2382866
• DOI: http://doi.org/10.3904/kjim.2015.240

Abstract

BACKGROUND/AIMS
Healthcare-associated infections (HAIs) in critically ill patients with prolonged length of hospital stay and increased medical costs. The aim of this study is to assess whether daily chlorhexidine gluconate (CHG) bathing will significantly reduce the rates of HAIs in adult intensive care units (ICUs).
METHODS
PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched until December 31, 2014 to identify relevant studies. Two authors independently reviewed and extracted data from included studies. All data was analyzed by Review Manager version 5.3.
RESULTS
Fifteen studies including three randomized controlled trials and 12 quasi-experimental studies were available in this study. The outcomes showed that daily CHG bathing were associated with significant reduction in the rates of primary outcomes: catheter-related bloodstream infection (risk ratio [RR], 0.44; 95% confidence interval [CI], 0.32 to 0.63; p < 0.00001), catheter-associated urinary tract infection (RR, 0.68; 95% CI, 0.52 to 0.88; p = 0.004), ventilator-associated pneumonia (RR, 0.73; 95% CI, 0.57 to 0.93; p = 0.01), acquisition of methicillin-resistant Staphylococcus aureus (RR, 0.78; 95% CI, 0.68 to 0.91; p = 0.001) and vancomycin-resistant Enterococcus (RR, 0.56; 95% CI, 0.31 to 0.99; p = 0.05).
CONCLUSIONS
Our study suggests that the use of daily CHG bathing can significantly prevent HAIs in ICUs. However, more well-designed studies are needed to confirm these findings.

Keyword

Chlorhexidine gluconate; Bathing; Infection; Intensive care units

MeSH Terms

Adult*
Baths*
Chlorhexidine*
Critical Care*
Critical Illness
Enterococcus
Humans
Intensive Care Units*
Length of Stay
Methicillin-Resistant Staphylococcus aureus
Non-Randomized Controlled Trials as Topic
Pneumonia, Ventilator-Associated
Urinary Tract Infections
Chlorhexidine