Does oral hygiene prevents nosocomial infections in hospitalized patients? A systematic review and meta-analysis.

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Medicina Oral Patologia Oral Y Cirugia Bucal Pub Date : 2025-03-01 DOI:10.4317/medoral.26706

K-M Miyahira, M-L Martins, W-F Liberato, M-B Magno, D-D Ferreira, J-R Tenório, L-C Maia, G-F Castro

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引用次数: 0

Abstract

Background: This study aimed to evaluate the impact of oral hygiene (OH) with chlorhexidine (CHX) on the evolution of nosocomial infections (NI).

Material and methods: Electronic searches were carried out in PubMed, Scopus, Cochrane Library, Web of Science, VHL, and Grey Literature databases. Randomized clinical trials were included. Methodological quality and risk of bias were assessed using RoB 2.0. Meta-analyses were carried out comparing patients who did or did not receive OH with CHX (0.05%, 0.12% and 2%) for NI, Ventilator-Associated Pneumonia (VAP), S. aureus infection (SA), duration of mechanical ventilation (MV), length of hospital stay and Intensive Care Unit (ICU). The certainty of evidence (CE) was evaluated with GRADE approach.

Results: Thirteen studies were selected for quantitative and qualitative synthesis. The risk for VAP (RR 0.72 [0.58, 0.90], p=0.003) and NI (RR 0.70 [0.58, 0.83], p<0.001) were lower in patients of the CHX groups compared to controls, independently for [CHX] used for NI (RR≥0.49, p≤0.03). Patients who received CHX 2×/day presented similar risk to control (RR 0.98 [0.75, 1.30], p=0.91); while 3 and 4×/day or more (RR≥0.52, p≤0.002) presented lower risk for NI. Similar risk for SA was observed among groups (RR 0.42 [0.14, 1.26], p=0.12). The average days of hospitalization (p=0.67), ICU stay (p=0.37) and MV (p=0.57) did not differ between the groups. CE ranged from very low to moderate.

Conclusions: OH with CHX reduced NI, regardless of concentration, when used 3×/day or more. However, it had no effect against AS and did not reduce length of hospital stay.

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来源期刊

Medicina Oral Patologia Oral Y Cirugia Bucal DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

3-8 weeks

期刊介绍： 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology