This literature review compares two studies on the use of chlorhexidine gluconate (CHG) baths to reduce central line-associated bloodstream infections (CLABSIs) in critically ill patients. Both studies were systematic reviews and meta-analyses that found CHG baths reduced the risk of CLABSIs and other healthcare-associated infections. The first study found a 56% reduction in CLABSIs while the second found a 0.67 reduction. While the studies used different primary outcomes, they both ultimately recommended the routine use of CHG baths to decrease CLABSIs in adult ICU patients.

1. Central Line-Associated Bloodstream Infections
Central Line-Associated Bloodstream InfectionsThis literature review seeks to compare and
contrast peer-reviewed sources for literature that supports CHG baths as an intervention
for reducing the incidences of CLABSIs among critically ill patients. According to Bell &
O'Grady (2017), seriously ill patients who are hospitalize in the ICU require central lines for
safety when administering IV drugs, during IV fluid replacement, to help in monitoring
patient's hemodynamic parameters when managing patients with cardiogenic shock,
pulmonary hypertension and decompensated heart failure. Irrespective of these numerous
benefits, central lines are a potential entry point for localized and systemic bloodstream
infections, which leads to CLABSIs.CLABSIs tend to occur within 48 hours after central line
placement. As one of the most common and significant HAIs, they have a huge economic
burden where approximately $46,000 is used to manage a single case. Annually in the US,
reported cases of CLABSIs to exceed 500,000 with a mortality rate of between 10-30% (Bell
& O'Grady, 2017). Research suggests that chlorhexidine gluconate (CHG) baths are an
effective intervention of preventing and reducing deaths related to CLABSIs since it has a
prolonged residual effect. However, there is very little supporting evidence for use of CHG
baths to decrease incidences of CLABSIs in critically ill patients.Central Line-Associated
Bloodstream InfectionsORDER A PLAGIARISM-FREE PAPER HEREComparison and Contrast
of Peer-Reviewed EBP SourcesIn a systematic review and meta-analysis that was conducted
by Musuuza et al., (2019), the aim was to examine how CHQ baths impacted HAIs. The study
was influenced by the background knowledge of unclear data regarding the degree of the
effect and patient-centric outcomes of chlorhexidine baths on patients. They postulated that
chlorhexidine baths reduce the incidences of CLABSIs among ICU and general population
patients. Musuuza et al., (2019) searched the online databases of EMBASE, Scopus, Medline,
CINAHL, and Cochrane. This search included RCTs, cluster RCTs, and quasi-experimental
studies and excluded studies with pediatric populations. The primary outcomes were
patient-centric outcomes such as comfort and HABSIs. Their study included 26 articles with
861,546 patients and 5259 incidences of HABSIs.Similarly, Frost et al., (2016) also
conducted a systematic review and meta-analysis that purposed to establish if
chlorhexidine baths for adult patients in the ICU are effective in decreasing infection. In
contrast, the primary outcomes in their search were HABSIs such as MRSA, CLABSIs, CAUTI
and vancomycin-resistant enterococcus. The final analysis included seven cluster
RCTs.Musuuza et al., (2019) found consistency in the intervention and control groups: 0.67,
95% and 0.54, 95%. The researcher has therefore suggested that and the researchers

2. suggested that bathing patients with chlorhexidine reduce HABSIs incidences in non-ICU an
ICU settings. Comparatively, Frost et al., (2016) found that chlorhexidine baths reduced the
risks of CLABSIs by 56%. Bacteremia and skin colonization by MRSA by 36% and 41%. They
further conclude that chlorhexidine baths reduce infections with MRSA's and CLABSIs.A
major limitation in Frost et al. (2016) study is the inclusion of a study that had a control and
screening group compared to a general group that only used chlorhexidine baths and
additional mupirocin. In contrast, Musuuza et al., (2019) only used an adult population
sample in their study, which implies that the findings cannot be applied to pediatric
populations.ConclusionThis literature review compares and contrasts peer-reviewed
sources that support CGH baths as an effective intervention of decreasing incidences of
CLABSIs. Both studies were systematic reviews and meta-analysis with adult population
samples. However, the studies used different primary outcome measures but ultimately
recommended routinely using CHG baths to decrease the incidences and associated risks of
CLABSIs among adult hospitalized patients I the ICU.Central Line-Associated Bloodstream
InfectionsReferencesFrost, S. A., Alogso, M. C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R.,
& Hillman, K. M. (2016). Chlorhexidine bathing and healthcare-associated infections among
adult intensive care patients: a systematic review and meta-analysis. Critical Care, 20(1),
379.Musuuza, J. S., Guru, P. K., O’Horo, J. C., Bongiorno, C. M., Korobkin, M. A., Gangnon, R. E.,
& Safdar, N. (2019). The impact of chlorhexidine bathing on hospital-acquired bloodstream
infections: a systematic review and meta-analysis. BMC infectious diseases, 19(1),
416.Boonyasiri, A., Thaisiam, P., Permpikul, C., Judaeng, T., Suiwongsa, B., Apiradeewajeset,
N., & Thamlikitkul, V. (2016). Effectiveness of chlorhexidine wipes for the prevention of
multidrug-resistant bacterial colonization and hospital-acquired infections in intensive care
unit patients: a randomized trial in Thailand. infection control & hospital
epidemiology, 37(3), 245-253.Bell, T., & O'Grady, N. P. (2017). Prevention of Central Line-
Associated Bloodstream Infections. Infectious disease clinics of North America, 31(3), 551–
559. https://doi.org/10.1016/j.idc.2017.05.007Central Line-Associated Bloodstream
Infections