Chlorhexidine Bathing for Infection Prevention in Intensive Care Units

Chlorhexidine bathing involves the routine cleansing of patients’ skin with a chlorhexidine gluconate solution or impregnated cloths to reduce microbial burden and prevent healthcare-associated infections. In intensive care units (ICUs), patients are at heightened risk of bloodstream and device-related infections due to invasive devices, immunosuppression and prolonged hospital stays. By lowering the density of skin commensals, particularly gram-positive cocci, chlorhexidine bathing disrupts the reservoir for potential pathogens, thereby reducing the incidence of central line-associated bloodstream infections (CLABSIs) and other device-related complications. Implementation as part of a multifaceted infection-prevention bundle has become widespread, though uptake varies according to local policy, resource availability and concerns over resistance or skin reactions. Globally, recommendations favour daily or every-other-day bathing with 2% chlorhexidine-impregnated cloths or 0.12–4% chlorhexidine solutions, integrated alongside hand hygiene, environmental cleaning and antimicrobial stewardship. Practical considerations include supply chain consistency, staff training, patient tolerance and monitoring of skin integrity. Overall, chlorhexidine bathing represents a scalable, cost-effective intervention with demonstrable benefits in high-risk critical care settings.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Chlorhexidine Bathing for Infection Prevention in Intensive Care Units publication trend

The graph below shows the total number of articles in chlorhexidine bathing for infection prevention in intensive care units across all publications each year (not limited to Nature Index journals).

Technical terms

Chlorhexidine gluconate: A broad-spectrum antiseptic agent used topically to reduce skin microbial counts.

Antiseptic bathing: The process of cleansing skin with an antimicrobial agent to prevent pathogen transmission and infection.

Central line-associated bloodstream infection (CLABSI): A bloodstream infection originating from an intravascular catheter, confirmed by laboratory findings.

Colonisation: The presence and growth of microorganisms on or in a host without causing symptomatic infection.

References

1. Central-line associated bloodstream infections in intensive care units before and after implementation of daily antiseptic bathing with chlorhexidine or octenidine: a post-hoc analysis of a cluster-randomised controlled trial. Antimicrobial Resistance & Infection Control (2023).
2. Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: a systematic review and meta-analysis of randomised crossover trials. Eurosurveillance (2016).
3. Chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. Critical Care (2016).