Journals / Hemşirelikte Araştırma Geliştirme Dergisi / 2026 / Cilt: 28 Sayı: 2

Chlorhexidine Gluconate Bathing in Hospital-Based Infection Prevention and Control: A Bibliometric Analysis

Hastane Temelli Enfeksiyon Önleme ve Kontrolünde Klorheksidin Glukonat Banyosu: Bibliyometrik Bir Analiz

Gül Hatice Tarakçıoğlu Çelik(HACETTEPE ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)0000-0002-1376-4259
Pages
132–148
Publication Date
2026-08-14
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Citation-based analyses indicated that the field is supported by a cohesive and clinically oriented evidence base dominated by influential intervention studies and infection prevention journals.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: This study aimed to provide a comprehensive bibliometric analysis of the scientific literature on chlorhexidine gluconate (CHG) bathing in hospital-based infection prevention and control (IPC).
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Key Findings & Data:Methods: A bibliometric analysis was conducted using publications retrieved from the Web of Science Core Collection database on March 15, 2026.
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Conclusion & Impact:Citation-based analyses indicated that the field is supported by a cohesive and clinically oriented evidence base dominated by influential intervention studies and infection prevention journals.
🔬Design:Araştırma Makalesi
📍Scope:2026 Verileri
⚙️Variables:Bibliyometri · Enfeksiyon kontrolü · Klorheksidin glukonat

Abstract

Objective: This study aimed to provide a comprehensive bibliometric analysis of the scientific literature on chlorhexidine gluconate (CHG) bathing in hospital-based infection prevention and control (IPC). Methods: A bibliometric analysis was conducted using publications retrieved from the Web of Science Core Collection database on March 15, 2026. A structured search strategy combining terms related to chlorhexidine, bathing or decolonization practices, healthcare settings, and infection prevention was applied. Following title and abstract screening according to predefined eligibility criteria, 305 publications were included. Bibliometric indicators and network analyses were performed to examine publication trends, citation performance, collaboration patterns, and research themes. Results: The findings demonstrated a steady increase in CHG bathing research over time, with a marked growth beginning around 2016. The 305 publications received 11,506 citations, with an average of 37.72 citations per publication and an h-index of 52. The United States was the leading contributor in terms of publication output and international collaboration. Keyword co-occurrence analysis revealed that the literature is primarily focused on intensive care units, healthcare-associated infection prevention, decolonization strategies, and multidrug-resistant organisms. Citation-based analyses indicated that the field is supported by a cohesive and clinically oriented evidence base dominated by influential intervention studies and infection prevention journals.

Özet

Amaç: Bu çalışma, hastane temelli enfeksiyon önleme ve kontrolünde klorheksidin glukonat (CHG) banyosu kullanımıyla ilgili bilimsel literatürün kapsamlı bir bibliyometrik analizini gerçekleştirmeyi amaçlamıştır. Yöntem: 15 Mart 2026 tarihinde Web of Science Core Collection veritabanından elde edilen yayınlar kullanılarak bir bibliyometrik analiz gerçekleştirilmiştir. Klorheksidin, banyo veya dekolonizasyon uygulamaları, sağlık hizmeti ortamları ve enfeksiyon önleme ile ilişkili terimleri içeren yapılandırılmış bir arama stratejisi kullanılmıştır. Önceden belirlenen uygunluk kriterlerine göre başlık ve özet taramasının ardından 305 yayın analize dahil edilmiştir. Yayın eğilimleri, atıf performansı, iş birliği örüntüleri ve araştırma temalarının incelenmesi amacıyla bibliyometrik göstergeler ve ağ analizleri gerçekleştirilmiştir. Bulgular: Sonuçlar, CHG banyosu araştırmalarının zaman içerisinde düzenli olarak arttığını ve özellikle 2016 yılı civarında belirgin bir büyüme gösterdiğini ortaya koymuştur. Analize dahil edilen 305 yayın toplam 11.506 atıf almış olup yayın başına ortalama atıf sayısı 37,72 ve h-indeksi 52 olarak belirlenmiştir. Amerika Birleşik Devletleri hem yayın sayısı hem de uluslararası iş birlikleri açısından en üretken ülke olarak öne çıkmıştır. Anahtar sözcük eş-oluşum analizi, literatürün ağırlıklı olarak yoğun bakım üniteleri, sağlık bakımı ilişkili enfeksiyonların önlenmesi, dekolonizasyon stratejileri ve çoklu ilaca dirençli mikroorganizmalar etrafında şekillendiğini göstermiştir. Atıf temelli analizler ise alanın, etkili girişim çalışmaları ve enfeksiyon önleme dergileri tarafından desteklenen bütüncül ve klinik odaklı bir kanıt temeline sahip olduğunu ortaya koymuştur. Sonuç: Bulgular, CHG banyosu araştırmalarının gelişimini ve mevcut bilgi yapısını kapsamlı biçimde ortaya koymaktadır. Araştırma eğilimlerinin, etkili kanıtların ve mevcut bilgi boşluklarının belirlenmesi; hemşirelerin, enfeksiyon önleme ve kontrol profesyonellerinin, araştırmacıların ve sağlık yöneticilerinin kanıta dayalı uygulamaları güçlendirmesine ve gelecekteki araştırma önceliklerinin belirlenmesine katkı sağlayabilir.

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Cite This Article

Çelik, G. H. T. (2026). Chlorhexidine Gluconate Bathing in Hospital-Based Infection Prevention and Control: A Bibliometric Analysis. Hemşirelikte Araştırma Geliştirme Dergisi, Cilt: 28 Sayı: 2, 132–148. https://ajindex.com/articles/1408112

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References (50)

  1. Armellino, D., Woltmann, J., Parmentier, D., Musa, N., Eichorn, A., Silverman, R., … Farber, B. (2014). Modifying the risk: once-a-day bathing "at risk" patients in the intensive care unit with chlorhexidine gluconate. American Journal of Infection Control, 42(5), 571-573. doi:10.1016/j.ajic.2013.12.026
  2. Babiker, A., Lutgring, J. D., Fridkin, S., & Hayden, M. K. (2021). Assessing the Potential for Unintended Microbial Consequences of Routine Chlorhexidine Bathing for Prevention of Healthcare-associated Infections. Clinical Infectious Diseases, 72(5), 891-898. doi:10.1093/cid/ciaa1103
  3. Bleasdale, S. C., Trick, W. E., Gonzalez, I. M., Lyles, R. D., Hayden, M. K., & Weinstein, R. A. (2007). Effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical intensive care unit patients. Archives of Internal Medicine, 167(19), 2073-2079. doi:10.1001/archinte.167.19.2073
  4. Bode, L. G. M., Kluytmans, J., Wertheim, H. F. L., Bogaers, D., Vandenbroucke-Grauls, C., Roosendaal, R.,. Vos, M. C. (2010). Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus. The New England Journal of Medicine, 362(1), 9-17. doi:10.1056/NEJMoa0808939
  5. Centers for Medicare & Medicaid Services. (2026). Hospital-Acquired Condition Reduction Program. Retrieved from https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-acquired-condition-reduction-program-hacrp
  6. Chen, W. S., Lin, J. Z., Zhang, K., Fang, X. P., Wang, R., Sun, Q. M.,. Zhuang, G. H. (2025). Bathing with 2% chlorhexidine gluconate versus routine care for preventing surgical site infections after pancreatic surgery: a single-centre randomized controlled trial. Clinical Microbiology and Infection, 31(5), 825-831. doi:10.1016/j.cmi.2025.01.004
  7. Chlebicki, M. P., Safdar, N., O'Horo, J. C., & Maki, D. G. (2013). Preoperative chlorhexidine shower or bath for prevention of surgical site infection: A meta-analysis. American Journal of Infection Control, 41(2), 167-173. doi:10.1016/j.ajic.2012.02.014
  8. Climo, M. W., Sepkowitz, K. A., Zuccotti, G., Fraser, V. J., Warren, D. K., Perl, T. M.,. Wong, E. S. (2009). The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: results of a quasi-experimental multicenter trial. Critical Care Medicine, 37(6), 1858-1865. doi:10.1097/CCM.0b013e31819ffe6d
  9. Climo, M. W., Yokoe, D. S., Warren, D. K., Perl, T. M., Bolon, M., Herwaldt, L. A.,. Wong, E. S. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. The New England Journal of Medicine, 368(6), 533–542. doi:10.1056/NEJMoa1113849
  10. Dicks, K. V., Lofgren, E., Lewis, S. S., Moehring, R. W., Sexton, D. J., & Anderson, D. J. (2016). A Multicenter Pragmatic Interrupted Time Series Analysis of Chlorhexidine Gluconate Bathing in Community Hospital Intensive Care Units. Infection Control and Hospital Epidemiology, 37(7), 791-797. doi:10.1017/ice.2016.23
  11. Fan, C. Y., Lee, W. T., Hsu, T. C., Lee, C. H., Wang, S. P., Chen, W. S.,. Lee, C. C. (2019). Effect of chlorhexidine bathing on colonization or infection with Acinetobacter baumannii: a systematic review and meta-analysis. Journal of Hospital Infection, 103(3), 284-292. doi:10.1016/j.jhin.2019.08.004
  12. Forrester, J. D., Maggio, P. M., & Tennakoon, L. (2022). Cost of Health Care-Associated Infections in the United States. Journal of Patient Safety, 18(2), e477–e479. doi:10.1097/PTS.0000000000000845
  13. Frost, S. A., Alogso, M. C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R.,. Hillman, K. M. (2016). Chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. Critical Care, 20(1), 379. doi:10.1186/s13054-016-1553-5
  14. Hankins, R. J., Handke, L., Fey, P. D., Cavalieri, R. J., Cawcutt, K. A., Van Schooneveld, T.,. Rupp, M. E. (2025). Prospective, crossover, comparative study of two methods of chlorhexidine bathing. Infection Control and Hospital Epidemiology, 46(3), 243-248. doi:10.1017/ice.2024.243
  15. Harbarth, S., Fankhauser, C., Schrenzel, J., Christenson, J., Gervaz, P., Bandiera-Clerc, C.,. Pittet, D. (2008). Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA, 299(10), 1149-1157. doi:10.1001/jama.299.10.1149
  16. Huang, S. S., Septimus, E., Kleinman, K., Moody, J., Hickok, J., Avery, T. R.,. Platt, R. (2013). Targeted versus universal decolonization to prevent ICU infection. The New England Journal of Medicine, 368(24), 2255-2265. doi:10.1056/NEJMoa1207290
  17. Karki, S., & Cheng, A. C. (2012). Impact of non-rinse skin cleansing with chlorhexidine gluconate on prevention of healthcare-associated infections and colonization with multi-resistant organisms: a systematic review. Journal of Hospital Infection, 82(2), 71-84. doi:10.1016/j.jhin.2012.07.005
  18. Kitson, A., Conroy, T., Wengstrom, Y., Profetto-McGrath, J., & Robertson-Malt, S. (2010). Defining the fundamentals of care. International Journal of Nursing Practice, 16(4), 423-434. doi:10.1111/j.1440-172X.2010.01861.x
  19. Kitson, A. L., Muntlin Athlin, Å., & Conroy, T. (2014). Anything but basic: Nursing's challenge in meeting patients' fundamental care needs. Journal of Nursing Scholarship, 46(5), 331–339. doi:10.1111/jnu.12081 Lin, S. C., Lin, C. H., & Yu, C. C. (2017). Chlorhexidine bed-bath improves CLABSI: A meta-analysis. Journal of Nursing, 64(4), 71-78. doi:10.6224/JN.000056
  20. Milstone, A. M., Passaretti, C. L., & Perl, T. M. (2008). Chlorhexidine: expanding the armamentarium for infection control and prevention. Clinical Infectious Diseases, 46(2), 274-281. doi:10.1086/524736
  21. Milstone, A. M., Elward, A., Song, X., Zerr, D. M., Orscheln, R., Speck, K.,. Perl, T. M. (2013). Daily chlorhexidine bathing to reduce bacteraemia in critically ill children: a multicentre, cluster-randomised, crossover trial. Lancet, 381(9872), 1099-1106. doi:10.1016/s0140-6736(12)61687-0
  22. Musuuza, J. S., Guru, P. K., O'Horo, J. C., Bongiorno, C. M., Korobkin, M. A., Gangnon, R. E., & Safdar, N. (2019). The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: A systematic review and meta-analysis. BMC Infectious Diseases, 19(1), 416. doi:10.1186/s12879-019-4002-7
  23. Musuuza, J. S., Roberts, T. J., Hundt, A. S., Carayon, P., Zimbric, M. L., Schuetz, V.,. Safdar, N. (2020). Implementing daily chlorhexidine gluconate treatment for the prevention of healthcare-associated infections in non-intensive care settings: A multiple case analysis. PloS One, 15(4), e0232062. doi:10.1371/journal.pone.0232062
  24. Noto, M. J., Domenico, H. J., Byrne, D. W., Talbot, T., Rice, T. W., Bernard, G. R., & Wheeler, A. P. (2015). Chlorhexidine bathing and health care-associated infections: a randomized clinical trial. JAMA, 313(4), 369-378. doi:10.1001/jama.2014.18400
  25. O'Horo, J. C., Silva, G. L., Munoz-Price, L. S., & Safdar, N. (2012). The efficacy of daily bathing with chlorhexidine for reducing healthcare-associated bloodstream infections: a meta-analysis. Infection Control and Hospital Epidemiology, 33(3), 257-267. doi:10.1086/664496
  26. Peixoto, E. A. C., Poveda, V. B., Gnatta, J. R., & Oliveira, R. A. (2024). Bathing with wipes impregnated with chlorhexidine gluconate to prevent central line-associated bloodstream infection in critically ill patients: A systematic review with meta-analysis. American Journal of Infection Control, 52(6), 731-738. doi:10.1016/j.ajic.2024.01.019
  27. Pereira, A. P., Almeida-Santos, A. C., Duarte, B., Antunes, P., Peixe, L., Freitas, A. R., & Novais, C. (2025). Insights towards the impact of subinhibitory chlorhexidine on antimicrobial susceptibility and horizontal gene transfer in Enterococcus faecium. The Science of the Total Environment, 972, 179064. doi:10.1016/j.scitotenv.2025.179064
  28. Petlin, A., Schallom, M., Prentice, D., Sona, C., Mantia, P., McMullen, K., & Landholt, C. (2014). Chlorhexidine gluconate bathing to reduce methicillin-resistant Staphylococcus aureus acquisition. Critical Care Nurse, 34(5), 17-25. doi:10.4037/ccn2014943
  29. Popovich, K. J., Hota, B., Hayes, R., Weinstein, R. A., & Hayden, M. K. (2010). Daily skin cleansing with chlorhexidine did not reduce the rate of central-line associated bloodstream infection in a surgical intensive care unit. Intensive Care Medicine, 36(5), 854-858. doi:10.1007/s00134-010-1783-y
  30. Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A. M. (2021). Fundamentals of nursing (11th ed.). Elsevier.
  31. Reynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., & Granger, B. B. (2022). Program Evaluation of Implementation Science Outcomes From an Intervention to Improve Compliance With Chlorhexidine Gluconate Bathing: A Qualitative Study. Dimensions of Critical Care Nursing, 41(4), 200-208. doi:10.1097/DCC.0000000000000530
  32. Ritz, J., Pashnik, B., Padula, C., & Simmons, K. (2012). Effectiveness of 2 methods of chlorhexidine bathing. Journal of Nursing Care Quality, 27(2), 171-175. doi:10.1097/NCQ.0b013e3182398568 Scott, R. D., Culler, S. D., & Rask, K. J. (2019). Understanding the Economic Impact of Health Care-Associated Infections: A Cost Perspective Analysis. Journal of Infusion Nursing, 42(2), 61-69. doi:10.1097/NAN.0000000000000313
  33. Seo, J., & Song, R. (2021). [Effect of 2% Chlorhexidine Bathing on the Incidence of Hospital-Acquired Infection and Multidrug-Resistant Organisms in Adult Intensive Care Unit Patients: Systematic Review and Meta-Analysis]. Journal of Korean Academy of Nursing, 51(4), 414-429. doi:10.4040/jkan.21046
  34. Suwantarat, N., Carroll, K. C., Tekle, T., Ross, T., Sohn, S., Milstone, A. M., & Perl, T. M. (2014). High prevalence of reduced chlorhexidine susceptibility in organisms causing central line-associated bloodstream infections. Infection Control & Hospital Epidemiology, 35(9), 1183-1186. doi:10.1086/677624
  35. Tarakcioglu Celik, G. H. (2026). Chlorhexidine bathing in infection prevention and control: Clinical effectiveness, implementation, and emerging applications. Current Infectious Disease Reports, 28(1), 1-7. doi:10.1007/s11908-026-00884-4
  36. Tien, K. L., Sheng, W. H., Shieh, S. C., Hung, Y. P., Tien, H. F., Chen, Y. H.,. Chen, Y. C. (2020). Chlorhexidine Bathing to Prevent Central Line-Associated Bloodstream Infections in Hematology Units: A Prospective, Controlled Cohort Study. Clinical Infectious Diseases, 71(3), 556-563. doi:10.1093/cid/ciz874
  37. Vernon, M. O., Hayden, M. K., Trick, W. E., Hayes, R. A., Blom, D. W., Weinstein, R. A., & Chicago Antimicrobial Resistance, P. (2006). Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Archives of Internal Medicine, 166(3), 306-312. doi:10.1001/archinte.166.3.306
  38. Webster, J., & Osborne, S. (2006). Meta-analysis of preoperative antiseptic bathing in the prevention of surgical site infection. The British Journal of Surgery, 93(11), 1335-1341. doi:10.1002/bjs.5606
  39. Bode, L. G. M., Kluytmans, J., Wertheim, H. F. L., Bogaers, D., Vandenbroucke-Grauls, C., Roosendaal, R.,. Vos, M. C. (2010). Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus. The New England Journal of Medicine, 362(1), 9-17. doi:10.1056/NEJMoa0808939
  40. Chen, W. S., Lin, J. Z., Zhang, K., Fang, X. P., Wang, R., Sun, Q. M.,. Zhuang, G. H. (2025). Bathing with 2% chlorhexidine gluconate versus routine care for preventing surgical site infections after pancreatic surgery: a single-centre randomized controlled trial. Clinical Microbiology and Infection, 31(5), 825-831. doi:10.1016/j.cmi.2025.01.004
  41. Climo, M. W., Sepkowitz, K. A., Zuccotti, G., Fraser, V. J., Warren, D. K., Perl, T. M.,. Wong, E. S. (2009). The effect of daily bathing with chlorhexidine on the acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and healthcare-associated bloodstream infections: results of a quasi-experimental multicenter trial. Critical Care Medicine, 37(6), 1858-1865. doi:10.1097/CCM.0b013e31819ffe6d
  42. Climo, M. W., Yokoe, D. S., Warren, D. K., Perl, T. M., Bolon, M., Herwaldt, L. A.,. Wong, E. S. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. The New England Journal of Medicine, 368(6), 533–542. doi:10.1056/NEJMoa1113849
  43. Fan, C. Y., Lee, W. T., Hsu, T. C., Lee, C. H., Wang, S. P., Chen, W. S.,. Lee, C. C. (2019). Effect of chlorhexidine bathing on colonization or infection with Acinetobacter baumannii: a systematic review and meta-analysis. Journal of Hospital Infection, 103(3), 284-292. doi:10.1016/j.jhin.2019.08.004
  44. Frost, S. A., Alogso, M. C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R.,. Hillman, K. M. (2016). Chlorhexidine bathing and health care-associated infections among adult intensive care patients: a systematic review and meta-analysis. Critical Care, 20(1), 379. doi:10.1186/s13054-016-1553-5
  45. Hankins, R. J., Handke, L., Fey, P. D., Cavalieri, R. J., Cawcutt, K. A., Van Schooneveld, T.,. Rupp, M. E. (2025). Prospective, crossover, comparative study of two methods of chlorhexidine bathing. Infection Control and Hospital Epidemiology, 46(3), 243-248. doi:10.1017/ice.2024.243
  46. Harbarth, S., Fankhauser, C., Schrenzel, J., Christenson, J., Gervaz, P., Bandiera-Clerc, C.,. Pittet, D. (2008). Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA, 299(10), 1149-1157. doi:10.1001/jama.299.10.1149
  47. Huang, S. S., Septimus, E., Kleinman, K., Moody, J., Hickok, J., Avery, T. R.,. Platt, R. (2013). Targeted versus universal decolonization to prevent ICU infection. The New England Journal of Medicine, 368(24), 2255-2265. doi:10.1056/NEJMoa1207290
  48. Milstone, A. M., Elward, A., Song, X., Zerr, D. M., Orscheln, R., Speck, K.,. Perl, T. M. (2013). Daily chlorhexidine bathing to reduce bacteraemia in critically ill children: a multicentre, cluster-randomised, crossover trial. Lancet, 381(9872), 1099-1106. doi:10.1016/s0140-6736(12)61687-0
  49. Musuuza, J. S., Roberts, T. J., Hundt, A. S., Carayon, P., Zimbric, M. L., Schuetz, V.,. Safdar, N. (2020). Implementing daily chlorhexidine gluconate treatment for the prevention of healthcare-associated infections in non-intensive care settings: A multiple case analysis. PloS One, 15(4), e0232062. doi:10.1371/journal.pone.0232062
  50. Tien, K. L., Sheng, W. H., Shieh, S. C., Hung, Y. P., Tien, H. F., Chen, Y. H.,. Chen, Y. C. (2020). Chlorhexidine Bathing to Prevent Central Line-Associated Bloodstream Infections in Hematology Units: A Prospective, Controlled Cohort Study. Clinical Infectious Diseases, 71(3), 556-563. doi:10.1093/cid/ciz874