ReviewEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2022
Increasing usage of chlorhexidine in health care settings: blessing or curse? A narrative review of the risk of chlorhexidine resistance and the implications for infection prevention and control.
Review in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Pooled it
- Prevention of surgical site infections in lower limb fracture fixation and elective arthroplasty: a systematic review and meta-analysis of decolonization and skin antisepsis strategies.Antimicrobial resistance and infection control · 2026Pooled it
- Chlorhexidine vs Povidone-Iodine and Incidence of Catheter-Related Infections: A Systematic Review and Meta-Analysis.JAMA network open · 2026Pooled it
- An international randomised controlled trial of a novel antimicrobial dressing for peripheral intravenous catheters (ProP trial).Antimicrobial resistance and infection control · 2026Trial
- A Double-blind Randomized Trial of Oral Chlorhexidine Gluconate for Treatment of OralOpen forum infectious diseases · 2026Trial
- Evaluation of microbiological efficacy of 2% chlorhexidine gluconate cloths versus 4% chlorhexidine gluconate soap for preoperative preparation/shower in total joint arthroplasty: a single-centre randomised controlled trial.Antimicrobial resistance and infection control · 2025Trial
- Tailoring Drug Release Profiles From Electrospun Alginate Fibers Through Integration of Mesoporous Silica Nanoparticles.Advanced healthcare materials · 2026Article
- Exploratory Evaluation of Susceptibility Patterns of Clinical Isolates ofAntibiotics (Basel, Switzerland) · 2026Article
- Does alternate-day bathing with 2% chlorhexidine improve clinical outcomes in critically ill patients? A systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- Electroporation of pLI50 harboring qacA or qacB increases chlorhexidine minimal inhibitory concentrations in transformed Staphylococcus aureus strain RN4220.Scientific reports · 2026Article
- Sustained chlorhexidine susceptibility in clinical MRSA isolates despite recent exposure.JAC-antimicrobial resistance · 2026Article
- Surface Carrier Testing of Hospital Antiseptics AgainstPathogens (Basel, Switzerland) · 2026Article
- Tackling a global threat: a clinical scenario-based framework for preventing and managingFrontiers in cellular and infection microbiology · 2026Review
- Delayed shifts in salivary microbiota composition following long-term use of 0.06% chlorhexidine toothpaste.Frontiers in oral health · 2026Article
- Antibacterial Resin Composites with Sustained Chlorhexidine Release: One-Year In Vitro Study.Pharmaceutics · 2025Article
- Prevalence of mutations associated with tolerance to chlorhexidine and other cationic biocides amongMicrobiology (Reading, England) · 2025Article
- Antimicrobial Smart Dressings for Combating Antibiotic Resistance in Wound Care.Pharmaceuticals (Basel, Switzerland) · 2025Review
- A novel multilayer antimicrobial urinary catheter material with antimicrobial properties.Materials advances · 2025Article
- Implementation of 2% Chlorhexidine Bathing to Reduce Healthcare-Associated Infections Among Patients in the Intensive Care Unit.Microorganisms · 2025Article
- Hypromellose-, Gelatin- and Gellan Gum-Based Gel Films with Chlorhexidine for Potential Application in Oral Inflammatory Diseases.Gels (Basel, Switzerland) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chlorhexidine digluconate (CHG) is an antiseptic frequently used in hospitals to prevent healthcare-related infections. It is used in different formulations for skin antisepsis, oral care, patient bathing, and hand hygiene. Also, CHG impregnated vascular catheters and wound dressings contribute to increased exposure of hospital germs to this biocide. In the last decade, concerns are rising about decreasing susceptibility of microorganisms to CHG and its potential cross-resistance with antibiotics. This study reviewed the published data regarding the evidence of reduced CHG susceptibility, the cross-resistance with antibiotics, and the implications for infection control for S. aureus, coagulase-negative staphylococci, E. coli, K. pneumoniae, and P. aeruginosa. Despite incongruity in definitions of "resistance," increased CHG minimal inhibitory values of these pathogens have been described, and different mutations encoding for CHG efflux pumps have been identified. Clinical relevance of species with reduced susceptibility to CHG is debatable and cross-resistance with antibiotics remains controversial. However, some studies link the increased usage of CHG to multidrug resistance, and the potential cross-resistance with colistin for K. pneumoniae is of major concern. More research in this matter is necessary. For infection control, it is advisable to use CHG applications only for indications with a clear patient benefit. It is important to follow manufacturer's instructions, and exposure of microorganisms to sub-lethal CHG concentrations should be avoided.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.