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The effects of chlorhexidine gluconate bathing on health care-associated infection in intensive care units: A meta-analysis

Authors
 Ha Yeon Kim  ;  Woo Kyung Lee  ;  Sungwon Na  ;  Yun Ho Roh  ;  Cheung Soo Shin  ;  Jeongmin Kim 
Citation
 JOURNAL OF CRITICAL CARE, Vol.32 : 126-137, 2016 
Journal Title
 JOURNAL OF CRITICAL CARE 
ISSN
 0883-9441 
Issue Date
2016
MeSH
Baths* ; Catheter-Related Infections/prevention & control ; Chlorhexidine/administration & dosage ; Chlorhexidine/analogs & derivatives* ; Cross Infection/epidemiology ; Cross Infection/prevention & control* ; Disinfectants/administration & dosage* ; Gram-Positive Bacterial Infections/prevention & control ; Humans ; Intensive Care Units/statistics & numerical data* ; Methicillin-Resistant Staphylococcus aureus
Keywords
Chlorhexidine bathing ; Health care–associated infection ; Meta-analysis ; Risk ratio
Abstract
PURPOSE: 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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0883944115005626
DOI
10.1016/j.jcrc.2015.11.011
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Kim, Ha Yan(김하연)
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
Shin, Cheung Soo(신증수) ORCID logo https://orcid.org/0000-0001-7829-8458
Lee, Woo Kyung(이우경)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146464
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