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. 2015 Dec;5(1):31.
doi: 10.1186/s13613-015-0073-9. Epub 2015 Oct 7.

Efficacy of chlorhexidine bathing for reducing healthcare associated bloodstream infections: a meta-analysis

Eun Young Choi  1 , Dong-Ah Park  2 , Hyun Jung Kim  3   4 , Jinkyeong Park  5
Affiliations

Efficacy of chlorhexidine bathing for reducing healthcare associated bloodstream infections: a meta-analysis

Eun Young Choi et al. Ann Intensive Care. 2015 Dec.

Abstract

Background: We performed a meta-analysis of randomized controlled trials (RCTs) to determine if daily bathing with chlorhexidine decreased hospital-acquired BSIs in critically ill patients.

Methods: We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized controlled trials that compared daily bathing with chlorhexidine and a control in critically ill patients.

Results: This meta-analysis included five RCTs. The overall incidence of measured hospital-acquired BSIs was significantly lower in the chlorhexidine group compared to the controls 0.69 (95 % CI 0.55-0.85; P < 0.001; I (2) = 57.7 %). Gram-positive-induced (RR = 0.49, 95 % CI 0.41-0.58; P = 0.000; I (2) = 0.0 %) bacteremias were significantly less common in the chlorhexidine group. The incidence of MRSA bacteremias (RR 0.63; 95 % CI 0.44-0.91; P = 0.006; I (2) = 30.3 %) was significantly lower among patients who received mupirocin in addition to chlorhexidine bathing than among those who did not routinely receive mupirocin.

Conclusions: Daily bathing with chlorhexidine may be effective to reduce the incidence of hospital-acquired BSIs. However, chlorhexidine bathing alone may be of limited utility in reduction of MRSA bacteremia; intranasal mupirocin may also be required. This meta-analysis has several limitations. Future large-scale international multicenter studies are needed.

Keywords: Chlorhexidine; Critically ill; MRSA; Meta-analysis; Mupirocin.

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Figures

Fig. 1
Fig. 1
Flow-diagram of the selection criteria. Flow chart explaining the selection of eligible studies included in the meta-analysis
Fig. 2
Fig. 2
The overall incidence of hospital-acquired bloodstream infections. Each effect size is shown with its confidence interval (CI) as solid triangle. The overall effect and CI are shown as a diamond with a dotted line indicating its location. Vertical solid line at 1 indicates no treatment effect. M–H Mantel–Haenszel weighted fixed effects, D + L random-effects estimate
Fig. 3
Fig. 3
Gram-positive bacteria isolated from bloodstream infections. Each effect size is shown with its confidence interval (CI) as solid triangle. The overall effect and CI are shown as a diamond with a dotted line indicating its location. Vertical solid line at 1 indicates no treatment effect. M–H Mantel–Haenszel weighted fixed effects, D + L random-effects estimate
Fig. 4
Fig. 4
Methicillin resistant S. aureus isolated from bloodstream infections. Each effect size is shown with its confidence interval (CI) as solid triangle. The overall effect and CI are shown as a diamond with a dotted line indicating its location. Vertical solid line at 1 indicates no treatment effect. M–H Mantel–Haenszel weighted fixed effects, D + L random-effects estimate
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References

    1. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect Control Hosp Epidemiol. 2000;21(8):510–515. doi: 10.1086/501795. - DOI - PubMed
    1. Grundmann H, Aires-de-Sousa M, Boyce J, Tiemersma E. Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat. Lancet. 2006;368(9538):874–885. doi: 10.1016/S0140-6736(06)68853-3. - DOI - PubMed
    1. Kreman T, Hu J, Pottinger J, Herwaldt LA. Survey of long-term-care facilities in Iowa for policies and practices regarding residents with methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci. Infect Control Hosp Epidemiol. 2005;26(10):811–815. doi: 10.1086/502498. - DOI - PubMed
    1. Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10 Suppl 2):S65–S164. doi: 10.1016/j.ajic.2007.10.007. - DOI - PMC - PubMed
    1. Davis KA, Stewart JJ, Crouch HK, Florez CE, Hospenthal DR. Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis. 2004;39(6):776–782. doi: 10.1086/422997. - DOI - PubMed

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