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. 2025 Jan 2;13(1):65.
doi: 10.3390/microorganisms13010065.

Implementation of 2% Chlorhexidine Bathing to Reduce Healthcare-Associated Infections Among Patients in the Intensive Care Unit

Hsu-Liang Chang  1   2 , Tzu-Ying Liu  3   4 , Po-Shou Huang  4 , Chin-Hwan Chen  4 , Chia-Wen Yen  4 , Hui-Zhu Chen  4 , Shin-Huei Kuo  1   2   3   5 , Tun-Chieh Chen  1   2   3   6   7   8 , Shang-Yi Lin  1   2   5   6 , Po-Liang Lu  2   6   7   9
Affiliations

Implementation of 2% Chlorhexidine Bathing to Reduce Healthcare-Associated Infections Among Patients in the Intensive Care Unit

Hsu-Liang Chang et al. Microorganisms. .

Abstract

Healthcare-associated infections (HAIs) significantly increase morbidity, mortality, length of hospital stays, and costs, particularly among ICU patients. Despite standard interventions, catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) remain major HAI contributors. This study evaluated the efficacy of daily 2% chlorhexidine gluconate (CHG) bathing in reducing HAI incidence, specifically CAUTI, CLABSI, and multidrug-resistant organisms (MDROs), in a 20-bed ICU at a regional hospital. Using a prospective, uncontrolled before-and-after design, we compared traditional soap-water bathing (pre-intervention period) with CHG bathing over a one-year intervention and one-year post-intervention follow-up. The total number of patients and patient days admitted to the ICU per year were around 1330-1412 patients and 6702-6927 patient days, respectively, during 2018-2020. Results showed a significant reduction in HAI incidence rates from 3.43‱ to 0.58‱ (p < 0.05) during the intervention and sustained benefits post-intervention. Incidences of CAUTI and CLABSI decreased markedly (p < 0.05), with reduced MDRO isolates, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, carbapenem-resistant Acinetobacter baumannii, and Pseudomonas aeruginosa. Our findings support the implementation of daily CHG bathing as an effective strategy to reduce HAI and MDROs in ICU settings.

Keywords: catheter-associated bloodstream infections; catheter-associated urinary tract infections; chlorhexidine gluconate; healthcare-associated infections; multidrug-resistant organisms.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The processes of 2% chlorhexidine daily bathing.
Figure 2
Figure 2
The healthcare-associated infection densities and catheter-associated infection densities over the study periods.
Figure 3
Figure 3
The forest plot of meta-analysis on the effectiveness of chlorhexidine bathing for preventing urinary tract infections [13,14,15,16,17,18,19,20,21,22,23,24,25].
See this image and copyright information in PMC

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