title: The effects of chlorhexidine gluconate bathing on health care-associated infection in intensive care units: A meta-analysis.
abstract: OBJECTIVE
  The purpose was to assess the effects of chlorhexidine gluconate (CHG) bathing on health care-associated infections among critically ill patients.
  
  
  METHODS
  This 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).
  
  
  RESULTS
  Eighteen 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).
  
  
  CONCLUSIONS
  Daily 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.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752.
authors.forename: Ha Yeon
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752.
authors.forename: Sungwon
authors.initials: S
authors.lastname: Na
authors.affiliation: Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-Gu, Seoul, Republic of Korea, 120-752.
authors.forename: Yun Ho
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752.
authors.forename: Cheung Soo
authors.initials: CS
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 120-752. Electronic address: anesjeongmin@yuhs.ac.
authors.forename: Jeongmin
authors.initials: J
authors.lastname: Kim
mesh_terms: D001494:Baths; D055499:Catheter-Related Infections / Q000517:prevention & control; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004202:Disinfectants / Q000008:administration & dosage*; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D055624:Methicillin-Resistant Staphylococcus aureus
chemical_list: D004202:Disinfectants; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
keywords: Chlorhexidine bathing; Health care–associated infection; Meta-analysis; Risk ratio