Efficacy of chlorhexidine bathing for reducing healthcare associated bloodstream infections: a meta-analysis
- Authors
- Choi, Eun Young; Park, Dong-Ah; Kim, Hyun Jung; Park, Jinkyeong
- Issue Date
- 7-10월-2015
- Publisher
- SPRINGER
- Keywords
- Chlorhexidine; Mupirocin; MRSA; Critically ill; Meta-analysis
- Citation
- ANNALS OF INTENSIVE CARE, v.5
- Indexed
- SCIE
SCOPUS
- Journal Title
- ANNALS OF INTENSIVE CARE
- Volume
- 5
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/92207
- DOI
- 10.1186/s13613-015-0073-9
- ISSN
- 2110-5820
- 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.
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