title: Effects of daily bathing with chlorhexidine and acquired infection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus: a meta-analysis.
abstract: OBJECTIVE
  Chlorhexidine gluconate (CHG) is a common and safe antimicrobial agent and has been used widely in hand hygiene and skin disinfection; however, whether daily bathing with CHG results in the reduced acquired infection of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) remains inconclusive.
  
  
  METHODS
  We did a meta-analysis searching PubMed, Embase and the Cochrane Central Register database for available studies. Primary outcomes were acquired infection of MRSA, VRE.
  
  
  RESULTS
  In all, twelve articles were available in this review. We found that daily application of chlorhexidine bathing would significantly low the acquired colonization of MRSA [incidence rate ratio (IRR) =0.58, 95% confidence interval (CI): 0.41-0.82] or VRE (IRR =0.51, 95% CI: 0.36-0.73). Remarkably, the using of CHG bathing would significantly reduce the MRSA infection (IRR =0.56, 95% CI: 0.37-0.85), MRSA ventilator associated pneumonia (VAP) (IRR =0.22, 95% CI: 0.07-0.64) and VRE infection (IRR =0.57, 95% CI: 0.33-0.97). No significant publication bias was found in this meta-analysis.
  
  
  CONCLUSIONS
  The application of CHG bathing would significantly decrease acquired infection of MRSA or VRE, which may be an important complementary intervention to barrier precautions.
authors.affiliation: First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China;
authors.forename: Wensen
authors.initials: W
authors.lastname: Chen
authors.forename: Songqin
authors.initials: S
authors.lastname: Li
authors.forename: Lianhong
authors.initials: L
authors.lastname: Li
authors.forename: Xin
authors.initials: X
authors.lastname: Wu
authors.forename: Weihong
authors.initials: W
authors.lastname: Zhang
keywords: Chlorhexidine; methicillin-resistant Staphylococcus aureus (MRSA); vancomycin-resistant Enterococcus (VRE)