Evidence map›Paper›PMID 40635094›Full record

ArticleAntimicrobial resistance and infection control2025

Can chlorhexidine gluconate baths reduce fungal colonisation in intensive care unit patients?

Teresa Nascimento, João Inácio, Daniela Guerreiro, Patrícia Patrício, Luís Proença, Cristina Toscano, Priscila Diaz, Helena Barroso

Abstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Methods for skin load reduction of Candida auris: a systematic review.Antimicrobial resistance and infection control · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Teresa NascimentoSchool of Health & Science, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz, Caparica, Almada, 2829-511, Portugal. tnascimento@egasmoniz.edu.pt.ORCID 0000-0001-7695-8686
João InácioSchool of Applied Sciences, University of Brighton, Brighton, UK.ORCID 0000-0001-7367-5007
Daniela GuerreiroSchool of Health & Science, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz, Caparica, Almada, 2829-511, Portugal.ORCID 0009-0003-7181-4028
Patrícia PatrícioHospital da Luz, Setúbal, Portugal.ORCID 0000-0003-3025-0628
Luís ProençaSchool of Health & Science, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz, Caparica, Almada, 2829-511, Portugal.ORCID 0000-0002-8482-5936
Cristina ToscanoCentro Hospitalar Lisboa Ocidental Hospital Egas Moniz, Lisboa, Portugal.ORCID 0000-0002-4674-6065
Priscila DiazHospital Prof. Doutor Fernando da Fonseca, Amadora, Portugal.
Helena BarrosoSchool of Health & Science, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz, Caparica, Almada, 2829-511, Portugal.ORCID 0000-0003-4098-5433

Funding

Fundação para a Ciência e a Tecnologia 10.54499/UIDB/04585/2020
6 · The paper itself

Abstract

backgroundChlorhexidine Gluconate (CHG) bathing is widely used in Intensive Care Units (ICUs) to reduce bacterial colonisation, yet its efficacy against fungal skin colonisation, particularly Candida spp., is not well understood. This study aimed to evaluate the impact of daily CHG bathing on Candida colonisation among ICU patients.

methodsFrom 2020 to 2022, axillary/inguinal swabs were collected from 675 ICU patients across three units on admission (Day 1, D1), Day 5 (D5) and Day 8 (D8). Patients received daily CHG bathing (either 2% impregnated wipes or 4% liquid solution) from D1 to D5, followed by soap-and-water bathing from Day 6 to D8. Standard and molecular microbiological methods were used to identify fungal species, and colony-forming units (CFUs) were quantified. Colonisation rates and fungal burden were compared across time points and bathing protocols.

resultsA total of 988 swabs from 675 patients were collected, 675 on D1, 203 on D5 and 110 on D8. CHG bathing had no significant impact on Candida burden at individual time points, (D1, p = 0.223; D5, p = 0.939 and D8, p = 0.669). No significant differences in colonisation or fungal burden were observed between the use of 4% CHG solution and 2% CHG-impregnated wipes upon ICU admission. However, in the subgroup of 89 patients monitored longitudinally, a transient reduction in colonisation was observed during the CHG bathing period (D1-D5), followed by a significant increase during the soap-and-water period (D6-D8) (p = 0.005; between periods: p < 0.001). Among the 329 positive swabs, 274 yielded > 100 CFU/ml. High colony counts of C. albicans (> 1000 CFU/mL) were observed, with no significant association between colonisation levels and specific Candida species (p = 0.940).

conclusionsCHG bathing demonstrated only a limited and transient impact on Candida colonisation in ICU patients. Colonisation rates rebounded after cessation of CHG use, suggesting ongoing acquisition during ICU stay. These findings highlight the need for additional or alternative infection control measures targeting fungal pathogens in critical care settings.

Indexed as

Anti-Infective Agents, LocalBathsCandidaCandidiasisChlorhexidineCross InfectionIntensive Care UnitsAgedColony Count, MicrobialFemaleHumansMaleMiddle AgedAnti-Infective Agents, LocalChlorhexidinechlorhexidine gluconateCandida spp.Chlorhexidine gluconateColonisation; infection preventionIntensive care unit

Identifiers

PMID40635094
PMCPMC12243257

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Registered trials

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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.