Effect of chlorhexidine bathing on preventing health care-associated infections in ICU patients: A meta-analysis

Objective To assess the effects of chlorhexidine gluconate (CHG) bathing on health care–associated infections in ICU patients. Methods This meta-analysis evaluated studies from the PubMed, EMBASE, Cochrane Library, Web of Science database CNKI, WANFANG DATA and VIP. Two reviewers independently extracted data from included studies. The Cochrane Collaboration tool was used to evaluate all publications. Data were analyzed by Revman 5.3. Results Totally 13 trials were included, with 5 RCTs and 8 quasi-experimental studies. Compared with the control group, the intervention of CHG reduced the risk of central line-associated blood stream infection (CLABSI) by 37% (RR=0.64, 95% CI: 0.55-0.74, P< 0.001), skin infection by methicillinresistant staphylococcus aureus (MRSA) decreased by 45% (RR=0.51, 95% CI: 0.40-0.64, P< 0.001). There was no significant difference in incidence of catheter-associated urinary tract infection (CAUTI) between daily CHG bathing group (2.41 per 1 000 catheter-days) and standard bathing group (2.43 per 1 000 catheter-days), and incidence of ventilator-associated pneumonia (VAP) in daily CHG bathing group (2.03 per 1 000 ventilator-days) was not significantly different with that of standard bathing group (2.35 per 1 000 ventilator-days). Conclusion This meta-analysis reveals evidence for the benefit of daily bathing with CHG in reducing health care-associated infections, which may be associated with the decreasing of gram-positive bacteria on the skin.