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Meta-Analysis
. 2025 Mar 1;30(2):e179-e191.
doi: 10.4317/medoral.26706.

Does oral hygiene prevents nosocomial infections in hospitalized patients? A systematic review and meta-analysis

K-M Miyahira  1 , M-L Martins, W-F Liberato, M-B Magno, D-D Ferreira, J-R Tenório, L-C Maia, G-F Castro
Affiliations
Meta-Analysis

Does oral hygiene prevents nosocomial infections in hospitalized patients? A systematic review and meta-analysis

K-M Miyahira et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: This study aimed to evaluate the impact of oral hygiene (OH) with chlorhexidine (CHX) on the evolution of nosocomial infections (NI).

Material and methods: Electronic searches were carried out in PubMed, Scopus, Cochrane Library, Web of Science, VHL, and Grey Literature databases. Randomized clinical trials were included. Methodological quality and risk of bias were assessed using RoB 2.0. Meta-analyses were carried out comparing patients who did or did not receive OH with CHX (0.05%, 0.12% and 2%) for NI, Ventilator-Associated Pneumonia (VAP), S. aureus infection (SA), duration of mechanical ventilation (MV), length of hospital stay and Intensive Care Unit (ICU). The certainty of evidence (CE) was evaluated with GRADE approach.

Results: Thirteen studies were selected for quantitative and qualitative synthesis. The risk for VAP (RR 0.72 [0.58, 0.90], p=0.003) and NI (RR 0.70 [0.58, 0.83], p<0.001) were lower in patients of the CHX groups compared to controls, independently for [CHX] used for NI (RR≥0.49, p≤0.03). Patients who received CHX 2×/day presented similar risk to control (RR 0.98 [0.75, 1.30], p=0.91); while 3 and 4×/day or more (RR≥0.52, p≤0.002) presented lower risk for NI. Similar risk for SA was observed among groups (RR 0.42 [0.14, 1.26], p=0.12). The average days of hospitalization (p=0.67), ICU stay (p=0.37) and MV (p=0.57) did not differ between the groups. CE ranged from very low to moderate.

Conclusions: OH with CHX reduced NI, regardless of concentration, when used 3×/day or more. However, it had no effect against AS and did not reduce length of hospital stay.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of search results in databases.
Figure 2
Figure 2
Risk for nosocomial infection.
Figure 3
Figure 3
Risk for VAP infection.
Figure 4
Figure 4
Mean difference of days admitted in ICU.
See this image and copyright information in PMC

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