Assessment of Chlorhexidine Gluconate (CHG) Resistance in the Setting of Suboptimal Compliance of CHG Use on Medical Inpatient Units

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

“…There was strong evidence of benefit from twelve RCTs, 86-98 four controlled trials, [99][100][101][102] eleven ITS studies, [103][104][105][106][107][108][109][110][111][112][113] two retrospective cohort studies 114,115 and one CBA study 116 which investigated the effectiveness of CHG washing on the prevalence of MRSA colonisation, incidence of MRSA acquisition, incidence of MRSA infection and the eradication of MRSA. The results of the meta-analyses showed that decolonisation therapy with CHG, either alone or in combination with another agent (PVP, polysporin or mupirocin), was consistently better than the comparison group (either no decolonisation or placebo) for all outcomes, except for incidence of MRSA acquisition when CHG was used alone.…”

“…A small study assessing the effectiveness of CHG on the incidence of MRSA acquisition in patients with a peritoneal catheter found a benefit, although the sample size was too small to show a significant effect. 96 There was strong evidence from the meta-analysis of five studies 97,102,105,108,132 and one narratively-described cross-sectional study 135 which investigated resistance to CHG. Metaanalysis showed a high proportion of isolates which were resistant to CHG in the group of patients with CHG bathing, although the rates were still high (27.7%) in the comparison group where CHG was not used. The use of CHG significantly increased the incidence of resistant isolates (OR=2.79 [CI95% 1.81-4.26], p<0.0001).…”

“…There was moderate evidence from fourteen studies, 86,[88][89][90][91][92][93][94]96,97,99,100,102,109,121 which reported adverse events associated with the use of CHG. These included rash, 91,94,100 burning sensation, 92,97 itching, 92,94,97,100,109 redness, 92,109 dryness, 92 irritation, 97 fissures 97 and other not-specified skin reactions.…”