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.

Abstract

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.