title: The efficacy of daily chlorhexidine bathing for preventing healthcare-associated infections in adult intensive care units.
abstract: OBJECTIVE
  Healthcare-associated infections (HAIs) in critically ill patients with prolonged length of hospital stay and increased medical costs. The aim of this study is to assess whether daily chlorhexidine gluconate (CHG) bathing will significantly reduce the rates of HAIs in adult intensive care units (ICUs).
  
  
  METHODS
  PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched until December 31, 2014 to identify relevant studies. Two authors independently reviewed and extracted data from included studies. All data was analyzed by Review Manager version 5.3.
  
  
  RESULTS
  Fifteen studies including three randomized controlled trials and 12 quasi-experimental studies were available in this study. The outcomes showed that daily CHG bathing were associated with significant reduction in the rates of primary outcomes: catheter-related bloodstream infection (risk ratio [RR], 0.44; 95% confidence interval [CI], 0.32 to 0.63;p< 0.00001), catheter-associated urinary tract infection (RR, 0.68; 95% CI, 0.52 to 0.88;p= 0.004), ventilator-associated pneumonia (RR, 0.73; 95% CI, 0.57 to 0.93;p= 0.01), acquisition of methicillin-resistantStaphylococcus aureus(RR, 0.78; 95% CI, 0.68 to 0.91;p= 0.001) and vancomycin-resistantEnterococcus(RR, 0.56; 95% CI, 0.31 to 0.99;p= 0.05).
  
  
  CONCLUSIONS
  Our study suggests that the use of daily CHG bathing can significantly prevent HAIs in ICUs. However, more well-designed studies are needed to confirm these findings.
authors.affiliation: Nursing Administration, Mianyang Central Hospital, Mianyang, China.
authors.forename: Hua-Ping
authors.initials: HP
authors.lastname: Huang
authors.affiliation: Intensive Care Unit, Mianyang Central Hospital, Mianyang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Nursing Administration, Mianyang Central Hospital, Mianyang, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Wang
authors.affiliation: Nursing Administration, Mianyang Central Hospital, Mianyang, China.
authors.forename: Me
authors.initials: M
authors.lastname: He
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001494:Baths; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D016017:Odds Ratio; D012121:Respiration, Artificial / Q000009:adverse effects; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D012307:Risk Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D020713:Vancomycin Resistance; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000891:Anti-Infective Agents, Local; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
keywords: Bathing; Chlorhexidine gluconate; Infection; Intensive care units