Table 3.
Summary of findings
| Study | Patients included (n) | Duration (months) | Infection | Colonization |
|---|---|---|---|---|
| Batra [13] | 4,570 | 51 | 70 % reduction in acquisition of endemic MRSA strains (rate ratio 0.3), but increased acquisition (rate ratio 3.85) with an outbreak MRSA strain | |
| Bleasdale [10] | 836 | 12 | 61 % incidence reduction in all-cause primary BSIs; rate difference 6.3/1,000 ptdays 16.8 versus 6.4 BSIs per 1,000 central line-days (p = 0.01) | |
| No significant reduction in all-cause UTI, VAP, and secondary BSIs | ||||
| Camus [14] | 256 | 30 | No significant reduction in all-cause ICU-acquired infections (p = 0.919)a | |
| No significant reduction in all-cause total infectionsa | ||||
| No significant reduction in all-cause device-related infectionsb | ||||
| Climo [15] | 5,043 | 12 | No reduction in MRSA bacteremiac | 25 % reduction in acquisition of MRSA colonization (−0.66 per 1,000 ptdays)c |
| 78 % reduction in ICU acquired VRE bacteremias (−2.64 per 1,000 ptdays)c | 45 % reduction in acquisition of VRE colonization (−1.51 per 1,000 ptdays)c | |||
| Gould [16] | 2,653 | 48 | No significant reduction in MRSA or MSSA bacteremia | 11.4 decrease (p = 0.005) in proportion of patients with MRSA (colonization or infection) |
| Popovich [17] | 3,048 | 24 | No significant reduction in ICU-acquired all-cause CLABSIs (p = 0.57) | |
| Significant decrease in incidence rate of MRSA clinical cultures (0.68 versus 1.03 per 1,000 ptdays, p = 0.49) | ||||
| No significant reduction in ICU-acquired other infections (all p values >0.18) | ||||
| Raineri [18] | 3,978 | 120 | Decrease of MRSA infection rate from 3.5 to 1.7 per 1,000 ptdays (p = 0.0023) | |
| No significant difference in MRSA-VAP | ||||
| Decrease in MRSA-BSI incidence rate from 1.65 to 0.29 cases per 1,000 ptdays (p = 0.02) |
BSI bloodstream infection, CHG chlorhexidine gluconate, CHG-BW chlorhexidine gluconate body washing, CLABSI central line-associated bloodstream infection, MRSA methicillin-resistant Staphylococcus aureus, PO primary outcome, Ptdays patient-days, SO secondary outcome, TW-MRSA sequence type 239 MRSA outbreak strain, UTI urinary tract infection, VAP ventilator-associated pneumonia, Vent days ventilator days, VRE vancomycin-resistant Enterococci
aThere was a significant effect for the polymyxin/tobramycin plus CHG/mupirocin group when compared to each regimen alone and neither regimen
bThere was also no significant difference for the polymyxin/tobramycin plus CHG/mupirocin group when compared to each regimen alone and neither regimen
cOnly the results of the time-series analysis are presented
dFor period 1 compared to period 2. For the whole trial (period 1 to period 3), there was a significant decrease (p = 0.006 for trend)