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Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Ann+Intensive+Care 2015 ; 5 (ä): ä Nephropedia Template TP
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Efficacy of chlorhexidine bathing for reducing healthcare associated bloodstream infections: a meta-analysis #MMPMID26445950
Choi EY; Park DA; Kim HJ; Park J
Ann Intensive Care 2015[]; 5 (ä): ä PMID26445950show ga
Background: We performed a meta-analysis of randomized controlled trials (RCTs) to determine if daily bathing with chlorhexidine decreased hospital-acquired BSIs in critically ill patients. Methods: We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized controlled trials that compared daily bathing with chlorhexidine and a control in critically ill patients. Results: This meta-analysis included five RCTs. The overall incidence of measured hospital-acquired BSIs was significantly lower in the chlorhexidine group compared to the controls 0.69 (95 % CI 0.55?0.85; P < 0.001; I2 = 57.7 %). Gram-positive-induced (RR = 0.49, 95 % CI 0.41?0.58; P = 0.000; I2 = 0.0 %) bacteremias were significantly less common in the chlorhexidine group. The incidence of MRSA bacteremias (RR 0.63; 95 % CI 0.44?0.91; P = 0.006; I2 = 30.3 %) was significantly lower among patients who received mupirocin in addition to chlorhexidine bathing than among those who did not routinely receive mupirocin. Conclusions: Daily bathing with chlorhexidine may be effective to reduce the incidence of hospital-acquired BSIs. However, chlorhexidine bathing alone may be of limited utility in reduction of MRSA bacteremia; intranasal mupirocin may also be required. This meta-analysis has several limitations. Future large-scale international multicenter studies are needed.