The effects of chlorhexidine gluconate bathing on health care–associated infection in intensive care units: A meta-analysis

PurposeThe purpose was to assess the effects of chlorhexidine gluconate (CHG) bathing on health care–associated infections among critically ill patients.MethodsThis meta-analysis evaluated English-language studies from the PubMed, Embase, and Cochrane databases. The Cochrane Collaboration methodology was used to evaluate all publications regarding daily CHG bathing and the risks of acquiring central line–associated bloodstream infection (CLABSI), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE). Risk ratios (RRs) and the ratio of the log RRs (RRR) were estimated with 95% confidence intervals (CIs).ResultsEighteen studies were included. Compared with conventional care, the RRs (95% CIs) for CLABSI, MRSA, and VRE with CHG bathing were 0.45 (0.37-0.55), 0.67 (0.59-0.77), and 0.60 (0.42-0.85), respectively (all, P < .05). For MRSA acquisition, CHG bathing with concomitant nasal antibiotics provided a lower incidence compared with only CHG bathing (RRR: 0.81, 95% CI: 0.66-0.98, P = .035). Greater risk reduction was also observed in studies with prolonged interventions (RRR per 1-month extension: − 0.02, P = .027).ConclusionsDaily CHG bathing was associated with reduced risks of acquiring CLABSI, MRSA, and VRE. A prolonged intervention period and concomitant nasal antibiotic use were associated with lower risks of MRSA acquisition.