Long-Term Effects of Daily Versus Alternate-Day Chlorhexidine Bathing on Central-Line-Associated Blood Stream Infection in Medical Intensive Care Units: A Four-Year Observational Study.

BACKGROUND

Daily chlorhexidine gluconate (CHG) bathing may reduce central line-associated bloodstream infections (CLABSI) in critically ill patients, but evidence remains inconclusive, particularly regarding long-term effects and varying frequencies of use.

AIM

This study aimed to examine the association between different CHG bathing frequencies and CLABSI rates in medical intensive care units (MICUs).

STUDY DESIGN

A retrospective analysis was conducted in three MICUs in northern Taiwan from March 2018 to June 2022. One MICU implemented daily CHG bathing for 21 months, followed by every-other-day CHG bathing for 30 months, while two MICUs used water and soap as standard care. CLABSI rates per 1000 central line days and other clinical outcomes were compared.

RESULTS

Across 46 409 central line days and 5482 admissions, 357 CLABSI events were recorded. No significant difference in CLABSI rates was found between the CHG and standard care groups (IRR = 1.1, p = 0.36) or between the different CHG bathing frequencies (IRR = 0.68, p = 0.06). Other clinical outcomes showed no significant differences.

CONCLUSIONS

CHG bathing, whether daily or alternate-day, was not significantly associated with lowering CLABSI rates in MICU. The association may vary depending on hospital-specific conditions and infection profiles.

RELEVANCE TO CLINICAL PRACTICE

CHG bathing should not be regarded as a universal infection control strategy in ICUs. It should be evaluated within the context of each ICU's specific conditions and infection prevention strategy.