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.