Baño del paciente con clorhexidina en Unidad de Cuidados Intensivos para la prevención de Infecciones Asociadas a la Atención en Salud

Autores/as

  • Luis Felipe Chileno Camacho Universidad Tecnica Ambato
  • William Alarcón Universidad Técnica de Ambato

DOI:

https://doi.org/10.37117/higia.v9i2.900

Palabras clave:

Clorhexidina, Infecciones asociadas a la atención de la salud, Unidad de Cuidados intensivo.

Resumen

Resumen

Las infecciones relacionadas con la atención sanitaria (IAAS) constituyen una gran fuente de morbilidad y mortalidad. Los biocidas son componentes que cumplen un rol muy importante en la prevención de infecciones bacterianas. En los últimos años, el uso de la clorhexidina como medida de protección contra las infecciones asociadas a la atención en salud ha ido en aumento. Analizar la relevancia del baño del paciente con clorhexidina en Unidad de Cuidados Intensivos para la prevención de Infecciones Asociadas a la Atención en Salud.  Revisión descriptiva que emplea la recolección de información especializada de investigaciones y estudios clínicos tanto a nivel descriptivo, teórico como experimental enfocados en el uso de clorhexidina para pacientes con condiciones críticas en bases de datos: Scopus, PubMed, Medline, Scielo, Cinhal y Latindex mediante la ecuación de búsqueda “Clorhexidina and UCI”, en español, inglés y portugués entre los años de 2019 y 2023. Al aplicar los criterios de búsqueda se identifican 1028 artículos, luego de una selección más rigurosa se excluyen 840 documentos que no cumplen con los criterios. En la segunda fase de exclusión, de 188 artículos se descartan los documentos con contenido insuficiente obteniendo 35 artículos que cumplen con los criterios para proceder con la revisión sistemática. El baño con clorhexidina es una alternativa eficaz para reducir la adquisición y la colonización de bacterias grampositivas multirresistentes. Sin embargo, es necesario recopilar más evidencia para demostrar si esto finalmente reduce la infección, la duración de la estancia hospitalaria y la mortalidad en pacientes en estado crítico.

Citas

Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa F, Islam S, et al. Strategies to prevent healthcare-associated infections: A narrative overview [Internet]. Vol. 13, Risk Management and Healthcare Policy. Dove Medical Press Ltd; 2020 [cited 2023 Jun 18]. p. 1765–80. Available from: https://www.tandfonline.com/doi/epdf/10.2147/RMHP.S269315?needAccess=true&role=button

Bernadette B, Schreeder C, Davidson S. Implementation of chlorhexidine gluconate bathing to reduce HAIs Infection prevention Safety Solutions [Internet]. 2019. Available from: www.nursingmanagement.com

Brookes ZLS, Bescos R, Belfield LA, Ali K, Roberts A. Current uses of chlorhexidine for management of oral disease: a narrative review. J Dent [Internet]. 2020 Dec 1 [cited 2023 Jan 1];103:103497. Available from: /pmc/articles/PMC7567658/

Ma L, Diao X. Effect of chlorhexidine chip as an adjunct in non-surgical management of periodontal pockets: a meta-analysis. BMC Oral Health [Internet]. 2020 Sep 21 [cited 2023 Jan 1];20(1). Available from: /pmc/articles/PMC7507294/

Fernandez M dos S, Guedes MIF, Langa GPJ, Rösing CK, Cavagni J, Muniz FWMG. Virucidal efficacy of chlorhexidine: a systematic review. Odontology [Internet]. 2022 Apr 1 [cited 2023 Jan 2];110(2):376–92. Available from: https://pubmed.ncbi.nlm.nih.gov/34637092/

Wade RG, Burr NE, Mccauley G, Bourke G, Efthimiou O. The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis. Ann Surg. 2021 Dec 1;274(6):E481–8.

World Health Organization. World Health Organization model list of essential medicines: 21st list 2019 [Internet]. 2019 [cited 2023 Jan 1]. Available from: https://apps.who.int/iris/handle/10665/325771

Huang S. Chlorhexidine-based decolonization to reduce healthcare-associated infections and multidrug-resistant organisms (MDROs): who, what, where, when, and why? [Internet]. Vol. 103, Journal of Hospital Infection. W.B. Saunders Ltd; 2019 [cited 2022 Dec 29]. p. 235–43. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0195670119303603

Centers for Disease Control and Prevention CDC. Healthcare-associated infections [Internet]. 2020 [cited 2023 Jan 2]. Available from: https://www.cdc.gov/spanish/signosvitales/proteger-pacientes/index.html

Sánchez Granados JM, Serrano Ayestarán O, González Salas E, Gutiérrez Marqués S. Infección relacionada con el catéter venoso central. 2021 [cited 2023 Jan 2]; Available from: https://www.aeped.es/sites/default/files/documentos/40_infeccion_cateter_venoso_central.pdf

Perozo-Mena A, Castellano González MJ, Patricia L, Gamboa G. Infecciones asociadas a la atención en salud. Enfermería Investiga [Internet]. 2020 Mar 9 [cited 2023 Jan 2];5(2):48–61. Available from: https://revistas.uta.edu.ec/erevista/index.php/enfi/article/view/877

Reinoso J, Rojas M, Cherrez L, Guale L. Vista de Infecciones asociadas a la atención en salud: un desafío para la salud pública . 2022 [cited 2023 Jan 2]. Vista de Infecciones asociadas a la atención en salud: un desafío para la salud pública | Ciencia Latina Revista Científica Multidisciplinar. Available from: https://ciencialatina.org/index.php/cienciala/article/view/3849/5842

Terreros M, Salazar J, Toala A. ARTÍCULO DE REVISIÓN. FASES DE ELABORACIÓN Y PROTOCOLO REVIEW ARTICLE. PHASES OF ELABORATION AND PROTOCOL [Internet]. Vol. 7, Revista Científica Universidad Odontológica Dominicana. 2019 [cited 2023 Mar 21]. Available from: https://revistacientificauod.files.wordpress.com/2019/06/5-revista-uod-enero-junio-2019.pdf

Alarcón M, Osorio S, Baena G. THE EVIDENCE-BASED MEDICINE PICO STRATEGY APPLIED TO DENTISTRY USING MESH, EMTREE AND DECS. Revista Facultad de Odontología. 2019 Jul 9;31(1–2).

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev [Internet]. 2021 Dec 1 [cited 2023 Mar 21];10(1). Available from: https://www.bmj.com/content/372/bmj.n71

Babiker A, Lutgring J, Fridkin S, Hayden M. Assessing the Potential for Unintended Microbial Consequences of Routine Chlorhexidine Bathing for Prevention of Healthcare-associated Infections. Clinical Infectious Diseases [Internet]. 2021 Mar 1 [cited 2022 Dec 28];72(5):891–8. Available from: https://watermark.silverchair.com/ciaa1103.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAsMwggK_BgkqhkiG9w0BBwagggKwMIICrAIBADCCAqUGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMv8onMB5sWijFU_D7AgEQgIICdgbDObnPDkFlG__p1ljipwoSU_s2HmH4zEyT91FKIOvgpJ0I4LlRtnMC9asysg0t_BR21of96ZIEBX8XIRCbAsEJmmBi4aBUrppIeWviG0iziqZODhlrqdS_CwJuGKNN2a0EnnBLMAA41LOEF0quFdfdG5CPb2EXIP8gkx84kq1VwlqzrQC-Suup82cW9--Gw3jWQzg31CoO3qYreJKynP3VSxh7tI7rxAUm2EmE-b12HMtR8sjfKCNaQn3qZAOcPI0LgCHs8qBE4wNFrzbWGrzA7fjJus4LLOsVnE3E3cx9Md3HWRu2CwgjY5qylXlEUrL4gk-hiDzd52Abwgk5aN-2DpDAnbWGg8zaIiGxDmUN_aict_DenuSNgxPfKWlpFZHk2Ynoww8d1cfEEMbumtURjgHEM0EnmE4Q7xG3T3ZQH3wWBuYzB-36hsGT2BZmpGgqVSKn_6A2XrPqlMqtgiCx_4w0h1T6aVrTmAjn1dnaR43__4YpdtUPQswBOEafcAtl7fN3dDjyZ7XckPPQPiZC5O0MSFHTqlNfwEvhvHutgvseRqMMpZSgb7rFUyVu_5geajTpLw_sBL_oh-KJswPo1u_nEkaumosJFsqiDTZ__ZC889YXPGfCjEORF8kn3YGJuVU1WoY_nUPJcXf5KHihvce-WOeJzUdBq78V6a5cj9rAFJyfWINWDHeI6hQpGtiQ2WqQDqSQcp6jaOkhmgvt9q2zlj26objRNhZEUfBeBHf0kXQR9SLop_Sl5-C6roF0acta3583gHFMSPY0mHBnymIZ9a49VE5gHd2rw0tfiuSp7Lw_iZjyq_92u8OOxK84fXX_Ww

Fan C, Lee W, Hsu T, Lee C, Wang S, Chen W, et al. Effect of chlorhexidine bathing on colonization or infection with Acinetobacter baumannii: a systematic review and meta-analysis [Internet]. Vol. 103, Journal of Hospital Infection. W.B. Saunders Ltd; 2019 [cited 2022 Dec 28]. p. 284–92. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0195670119303160

Gall E, Long A, Hall K. Chlorhexidine Bathing Strategies for Multidrug-Resistant Organisms: A Summary of Recent Evidence [Internet]. Vol. 16, www.journalpatientsafety.com J Patient Saf •. 2020. Available from: www.journalpatientsafety.com

Tien K, Wang J, Sheng W, Lin H, Chung P, Tsan C, et al. Chlorhexidine bathing to prevent healthcare-associated vancomycin-resistant Enterococcus infections: A cluster quasi-experimental controlled study at intensive care units. Journal of the Formosan Medical Association [Internet]. 2021 Mar 1 [cited 2022 Dec 28];120(3):1014–21. Available from: https://www.sciencedirect.com/science/article/pii/S0929664620304228

Musuuza J, Guru P, O’Horo J, Bongiorno C, Korobkin M, Gangnon R, et al. The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: A systematic review and meta-analysis. BMC Infect Dis [Internet]. 2019 May 14 [cited 2022 Dec 29];19(1). Available from: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4002-7

Tien K, Sheng W, Shieh S, Hung Y, Tien H, Chen Y, et al. Chlorhexidine bathing to prevent central line- associated bloodstream infections in hematology units: A prospective, controlled cohort study. Clinical Infectious Diseases [Internet]. 2020 Aug 1 [cited 2022 Dec 29];71(3):556–63. Available from: https://academic.oup.com/cid/article/71/3/556/5559426

Suh J, Kim N, Lee M, Lee S, Chun B, Lee C, et al. Real-world experience of how chlorhexidine bathing affects the acquisition and incidence of vancomycin-resistant enterococci (VRE) in a medical intensive care unit with VRE endemicity: a prospective interrupted time-series study. Antimicrob Resist Infect Control [Internet]. 2021 Dec 1 [cited 2022 Dec 29];10(1). Available from: https://link.springer.com/article/10.1186/s13756-021-01030-6

Martinez T, Baugnon T, Vergnaud E, Duracher C, Perie A, Bustarret O, et al. Central-line-associated bloodstream infections in a surgical paediatric intensive care unit: Risk factors and prevention with chlorhexidine bathing. J Paediatr Child Health [Internet]. 2020 Jun 1 [cited 2022 Dec 29];56(6):936–42. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.14780

Scheier T, Saleschus D, Dunic M, Fröhlich M, Schüpbach R, Falk C, et al. Implementation of daily chlorhexidine bathing in intensive care units for reduction of central line-associated bloodstream infections. Journal of Hospital Infection [Internet]. 2021 Apr 1 [cited 2022 Dec 29];110:26–32. Available from: https://www.sciencedirect.com/science/article/pii/S0195670121000244

Patel A, Parikh P, Dunn A, Otter J, Thota P, Fraser T, et al. Effectiveness of daily chlorhexidine bathing for reducing gram-negative infections: A meta-analysis. Infect Control Hosp Epidemiol [Internet]. 2019 Apr 1 [cited 2022 Dec 29];40(4):392–9. Available from: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/abs/effectiveness-of-daily-chlorhexidine-bathing-for-reducing-gramnegative-infections-a-metaanalysis/E915BB84C3252F5E5537ECDA5D98E4E3

Huang W, Qiao F, Cai L, Zhang W. Effect of Daily Chlorhexidine Bathing on Reducing Infections Caused by Multidrug-Resistant Organisms in Intensive Care Unit Patients: A Semi-Experimental Study with Parallel Controls. 2020; Available from: https://doi.org/10.21203/rs.3.rs-67636/v1

Bui L, Swan J, Perez K, Johnson M, Chen H, Colavecchia A, et al. Impact of Chlorhexidine Bathing on Antimicrobial Utilization in Surgical Intensive Care Unit. Journal of Surgical Research [Internet]. 2020 Jun 1 [cited 2022 Dec 29];250:161–71. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0022480420300433

Pallotto C, Fiorio M, De Angelis V, Ripoli A, Franciosini E, Quondam L, et al. Daily bathing with 4% chlorhexidine gluconate in intensive care settings: a randomized controlled trial. Clinical Microbiology and Infection [Internet]. 2019 Jun 1 [cited 2022 Dec 29];25(6):705–10. Available from: https://www.sciencedirect.com/science/article/pii/S1198743X18306347

Reis M, de Almeida M, Escudero D, Medeiros E. Chlorhexidine gluconate bathing of adult patients in intensive care units in São Paulo, Brazil: Impact on the incidence of healthcare-associated infection. Brazilian Journal of Infectious Diseases [Internet]. 2022 Jan 1 [cited 2022 Dec 29];26(1). Available from: https://www.scielo.br/j/bjid/a/R9fvZtt5CmWQZNTjsPhG48M/abstract/?lang=en

Rivera A, Ong A, Gonzales M. Effectiveness of Daily Chlorhexidine Bathing in Reducing Healthcare-Associated Infections in the Pediatric Intensive Care Unit [Internet]. Vol. 20, Pediatric Infectious Disease Society of the Philippines Journal. 2019 [cited 2022 Dec 29]. Available from: http://www.pidsphil.org/home/wp-content/uploads/2019/09/Vol-20-No-1_RIVERA_Chlorhexidine-Bathing-Revised6.pdf

Thompson L, Kaurich J, Abraham S. The Effectiveness of Daily Chlorhexidine Hygiene in Reducing Future Hospital-Acquired Infections for Hospitalized Patients [Internet]. 2021. Available from: www.ijsrm.humanjournals.com

Martinez M, Cruz F, Gaona N, Camacho A, Mercado R, Flores S, et al. The effect of chlorhexidine on Acinetobacter baumannii in intensive care units [Internet]. Vol. 14. 2022. Available from: http://ijm.tums.ac.ir

Chapman L, Hargett L, Anderson T, Galluzzo J, Zimand P. Chlorhexidine gluconate bathing program to reduce health care–Associated infections in both critically ill and non–critically ill patients. Crit Care Nurse [Internet]. 2021 [cited 2022 Dec 29];41(5):e1–8. Available from: https://aacnjournals.org/ccnonline/article/41/5/e1/31588/Chlorhexidine-Gluconate-Bathing-Program-to-Reduce

Georgieva D, Koleva G, Hristova I, Konstantinova D. Effect on Skin Microflora in Hygienic Bathing of Patients with Chlorhexidine Gluconate Disinfectant and Non-Rinse Product Оптимизиране на здравните грижи и дейности при коронарно-съдови процедури View project Optimizing Immediate Newborn Care Practices View project. Article in Health Science Journal [Internet]. 2020; Available from: https://www.researchgate.net/publication/346383401

Chapman L, Hargett L, Anderson T, Galluzzo J, Zimand P. Chlorhexidine gluconate bathing program to reduce health care–Associated infections in both critically ill and non–critically ill patients. Crit Care Nurse [Internet]. 2021 [cited 2023 Jun 18];41(5):e1–8. Available from: https://aacnjournals.org/ccnonline/article/41/5/e1/31588/Chlorhexidine-Gluconate-Bathing-Program-to-Reduce

Publicado

2023-12-30

Cómo citar

Chileno Camacho, L. F., & Alarcón, W. (2023). Baño del paciente con clorhexidina en Unidad de Cuidados Intensivos para la prevención de Infecciones Asociadas a la Atención en Salud. Revista Científica Higía De La Salud, 9(2). https://doi.org/10.37117/higia.v9i2.900