葡萄糖酸氯己定擦浴对ICU患者院内获得性感染影响的Meta分析OA

Objective To systematically evaluate the effects of chlorhexidine gluconate bathing on healthcare-associated infection(HAI)and clinical outcomes in intensive care unit(ICU)patients.Methods A literature search was conducted across PubMed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),and Wanfang Data for randomized controlled trial(RCT)comparing chlorhexidine gluconate sponge baths with conventional sponge baths,published from January 1,2000 to December 31,2022.Two investigators independently screened studies,extracted data,and assessed study quality.Meta-analysis was used to compare the differences in the incidence of HAI,bloodstream infection,lung infection,urinary tract infection,as well as the in-hospital mortality,ICU length of stay,and total hospital length of stay between the two groups.Results Twelve RCTs involving 128 927 ICU patients were included:63 038 in the chlorhexidine gluconate bathing group and 65 889 in the control group.Compared with the control group,chlorhexidine gluconate bathing group showed significantly lower incidence of HAI[1.93%(1 219/63 038)vs.2.26%(1 490/65 889);odds ratio(OR)=0.72,95%confidence interval(95%CI)was 0.62-0.83,P<0.000 01]and bloodstream infections[1.30%(476/36 573)vs.1.54%(648/41 968);OR=0.70,95%CI was 0.62-0.79,P<0.000 01].No significant differences between groups were found in lung infection,urinary tract infection,in-hospital mortality,or total hospital length of stay(all P>0.05).ICU length of stay was slightly longer in the chlorhexidine gluconate bathing group[mean difference(MD)=0.17 days,95%CI was 0.06-0.28,P=0.004],although the absolute difference was small.Conclusions Chlorhexidine gluconate bathing reduces HAI and bloodstream infections in ICU patients.Its effects on other infection outcomes,mortality,and length of stay require confirmation in further high-quality studies.