氯己定擦浴预防ICU病人多重耐药菌感染效果的Meta分析

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Effect of chlorhexidine bathing in preventing multi-drug-resistant bacterial infections in ICU patients：a Meta-analysis

ZHANG Qin，JIA Ping，WANG Li，XIE Caixia，SONG Huiqin，FU Yanmei，QIN Ruixue，LI Xinyu，GUO DanyangSichuan Academy of Medical Sciences，Sichuan Provincial People′s Hospital，Sichuan 610072 ChinaCorresponding Author  JIA Ping，E-mail：aonejia@126.com

Abstract  Objective：To systematically evaluate the preventive effect of chlorhexidine bathing on multidrug-resistant bacterial infections in ICU patients.Methods：Chinese and English literature on the effectiveness of chlorhexidine bathing in preventing multidrug-resistant bacterial infections in ICU patients were retrieved from the Cochrane Library，PubMed，Web of Science，EMbase，CNKI，WanFang Database，VIP database，and CBM. Two researchers independently screened the literature，evaluated quality，extracted data according to the inclusion and exclusion criteria，and used Stata 16.0 software to perform Meta-analysis.Results：A total of 11 studies involving 23 090 patients were finally included. Meta-analysis results showed that compared with conventional warm water or soapy water bathing，chlorhexidine can reduce multi-drug-resistant bacterial infections in ICU patients （OR=0.770，P<0.001），and the difference was statistically significant. Among them，chlorhexidine whole-body bathing can reduce vancomycin-resistant enterococci （VRE） （OR=0.664，P=0.004） and carbapenem-resistant Pseudomonas aeruginosa （CRPA） （OR=0.442，P=0.034）. Still，it cannot reduce the risk of infection with methicillin-resistant Staphylococcus aureus （MRSA） （OR=0.852，P=0.193） and carbapenem-resistant acinetobacter baumannii （CRAB） （OR=0.888，P=0.537）.Conclusions：Existing evidence shows that chlorhexidine bathing could reduce multi-drug-resistant bacterial infections in ICU patients，but it is only effective against some drug-resistant bacteria.

Keywords  multidrug-resistant bacteria;chlorhexidine bathing;methicillin-resistant staphylococcus aureus;vancomycin-resistant enterococci;Meta-analysis

摘要  目的：系统评价氯己定全身擦浴对重症监护室（ICU）病人多重耐药菌感染的预防效果。（剩余11620字）