Susceptibility of Nosocomial K. pneumoniae, P. aeruginosa, A. baumannii, and P. mirabilis Strains to a Chlorhexidine-Based Antiseptic Preparation | CMAC

Susceptibility of Nosocomial K. pneumoniae, P. aeruginosa, A. baumannii, and P. mirabilis Strains to a Chlorhexidine-Based Antiseptic Preparation

Clinical Microbiology and Antimicrobial Chemotherapy. 2015; 17(1):57-66

​ Detusheva E.V., Rodin V.B., Slukin P.V., Ershova O.N., Aleksandrova I.A., Kurdyumova N.V., Sazykina S.Yu., Dyatlov I.A., Fursova N.K.
chlorhexidine nosocomial resistance healthcare-associated infections planktonic bacteria biofilm
Section
Personal Experience
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2015; 17(1):57-66

Abstract

This study was performed to investigate activity of chlorhexidine-based antiseptic preparation «Dezin» against the following pathogens causing nosocomial respiratory tract infections (RTI) and urinary tract infections (UTI): Klebsiella pneumoniae (n=8), Pseudomonas aeruginosa (n=3), Acinetobacter baumannii (n=4) and Proteus mirabilis (n=3) isolated from patients in neurosurgery ICU in 2013, as well as reference strains of K. pneumoniae (n=1), P. aeruginosa (n=1), Escherichia coli (n=1), and Staphylococcus aureus (n=1). Antimicrobial activity of the antiseptic preparation was evaluated by microbial growth inhibition in planktonic state (microdrop) and protobiofilm-like state (cellulose patch). Distribution of tested strains by susceptibility of planktonic cells to chlorhexidine (expressed in minimal bactericidal concentration [MBC]) was the following (in order of increasing susceptibility): P. mirabilis (0.025%), P. aeruginosa (0.009%), K. pneumoniae (0.006%), A. baumannii (0.006%), E. coli (0.005%) и S. aureus (0.005%). Susceptibility of biofilmlike associations (on the surface of cellulose patches) to chlorhexidine was significantly decreased: 23 times in P. aeruginosa (MBC – 0.2%), 28 times in A. baumannii (MBC — 0.16%), 48 times in K. pneumoniae (MBC – 0.3%), 50 times in P. mirabilis (MBC — 1.3%), 128 times in E. coli (MBC — 0.6%), and 255 times in S. aureus (MBC — 1.3%). Based on the results, 1.5% chlorhexidine solution may be recommended as a measure to prevent nosocomial RTIs and UTIs in neurosurgery ICU patients.

Elena V. Detusheva

State Research Center for Applied Microbiology and Biotechnology, Obolensk, Russia

Rodin V.B.

State Research Center for Applied Microbiology and Biotechnology, Obolensk, Russia

Slukin P.V.

State Research Center for Applied Microbiology and Biotechnology, Obolensk, Russia

Ershova O.N.

Research Institute of Neurosurgery named after N.N. Burdenko, Moscow, Russia

Aleksandrova I.A.

Research Institute of Neurosurgery named after N.N. Burdenko, Moscow, Russia

Kurdyumova N.V.

Research Institute of Neurosurgery named after N.N. Burdenko, Moscow, Russia

Sazykina S.Yu.

Research Institute of Neurosurgery named after N.N. Burdenko, Moscow, Russia

Dyatlov I.A.

State Research Center for Applied Microbiology and Biotechnology, Obolensk, Russia

Fursova N.K.

State Research Center for Applied Microbiology and Biotechnology, Obolensk, Russia

  • 1. Программа ВОЗ по обеспечению безопасности пациентов. Всемирный альянс за безопасность пациентов. Глобальная задача по обеспечению безопасности пациентов. Чистая помощь — безопасная помощь. ВОЗ, Женева, 2006.
  • 2. Основные компоненты для программ профилактики инфекций и инфекционного контроля. Второе совещание неформальной сети по профилактике инфекций и инфекционному контролю в здравоохранении. Женева, Швейцария, 26-27 июня 2008 г.
  • 3. Гудкова Е.И., Адарченко А.А., Ласточкина Т.М., Симоненко Л.И., Слабко И.Н. Чувствительность к новым дезинфектантам клинических штаммов микробов, методы определения. Материалы юбилейной научной конференции, посвященной 80-летию Башкирского Государственного Медицинского Университета «Актуальные проблемы современной медицины» Под ред. С.Л. Кабака. Минск БГМУ 2001; 1:89-91.
  • 4. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0; 2014; http://www.eucast.org
  • 5. Gajadhar T., Lara A., Sealy P., Adesiyun A. A. Microbial contamination of disinfectants and antiseptics in four major hospitals in Trinidad. Rev Panam Salud Publica 2003; 14(3):193-200.
  • 6. O’Rourke E., Runyan D., O’Leary J. Contaminated iodophor in the operating room. Am J Infect Control 2003; 31:255-6.
  • 7. Weber D. J., Rutala W. A., Sickbert-Bennett E. E. Outbreaks associated with contaminated antiseptics and disinfectants. Antimicrob Agents Chemother 2007; 51(12):4217-24.
  • 8. Красильников А. П. Справочник по антисептике. Минск: Высш. шк. 1995.
  • 9. Weuffen W. Handbuch der Antiseptik. In 3 Bd; Berlin: Veb. Verlag Volk und Gesundheit 1984-1987.
  • 10. Aparna M. S., Yadav S. Biofilms: microbes and disease. Braz J Infect Dis 2008; 12(6):526-30.
  • 11. Costerton J. W., Stewart P. S., Greenberg E. P. Bacterial biofilms: a common cause of persistent infections. Science 1999; 284(5418):1318-22.
  • 12. Krzyściak W., Jurczak A., Kościelniak D., Bystrowska B, Skalniak A. The virulence of Streptococcus mutans and the ability to form biofilms. Clin Microbiol Infect Dis 2014; 33(4):499-515.
  • 13. Patel R. Biofilms and antimicrobial resistance. Clin Orthop Relat Res 2005; (437):41-7.
  • 14. Al-Tannir M.A., Goodman H. S. A review of clorhexidine and its use in special populations. Special Care in Dentistry 1994; 14:116-22.
  • 15. Gilbert P., Moore L. E. Cationic antiseptics: diversity of action under a common epithet. J App Microbiol 2005; 99:703-15.
  • 16. Ruppert M., Schlagenhauf U. La clorhexidina en Odontología. Aspectos generales. Quintessence (Ed. Española) 2005; 18:12-23.
  • 17. Hugo W. B. Disinfection mechanisms. In: Russell A. D., Hugo W. B., Ayliffe G. A.J., eds. Principles and Practice of Disinfection, Preservation and Sterilization. Oxford: Blackwell 1992:187-210.
  • 18. Albertos J. M., Junquera L. M., Albertos M. T., Olay S., López-Arranz E. La clorhexidina. Perspectiva actual. Еn Odontoestomatología 1996; 5:217-23.
  • 19. Musteata F. M., Pawliszyn J. Assay of stability, free and total concentration of chlorhexidine in saliva by solid phase microextraction. J Pharm Biomedical Analysis 2005; 37:1015-24.
  • 20. Hugo W. B., Longworth A. R. The effect of chlorhexidine on the electrophoretic mobility, cytoplasmic constituents, dehydrogenase activity and cell walls of Escherichia coli and Staphylococcus aureus. J Pharma Pharmacol 1966; 18:569-78.
  • 21. Fardal O., Turnbull R. S. A review of the literature on use of chlorhexidine in dentistry. J American Dental Association 1986; 112:863-9.
  • 22. Longworth A. R. Chlorhexidine. In: Hugo W. B., ed. Inhibition and destruction of the bacterial cell. New York, N.Y: Academic Press 1971:95-106.
  • 23. Arévalo J.M., Arribas J.L., Calbo L., Hernández M. J., Lizán M., Herruzco R. Guía del grupo de trabajo sobre desinfectantes y antisépticos. Revisión 1998. Medicina Preventiva 1998; 4:38-43.
  • 24. Bernimoulin J. P. Recent concepts in plaque formation. J Clin Periodontology 2003; 30:7-9.
  • 25. Junco-Lafuente M.P, Baca-García P., Mesa-Aguado F. L. Utilización de la clorhexidina en la prevención oral de pacientes de la tercera edad. Revista del Ilustre Consejo General de Colegios de Odontólogos y Estomatólogos de España 2001; 6:81-9.
  • 26. Rahimi S., Janani M., Lotfi M., et al. A review of antibacterial agents in endodontic treatment. Iran Endod J. 2014; 9(3):161-8.
  • 27. Зверьков А.В., Зузова А.П. Актуальность обработки полости рта 0,1% раствором хлоргексидина и очищенной водой для профилактики нозокомиальной пневмонии у больных с острым нарушением мозгового кровообращения. Тезисы XVI Международного конгресса МАКМАХ по антимикробной терапии; 21-23 мая 2014 г.; Москва, Россия. КМАХ 2014; 16(2):20.
  • 28. Bosca I.D., Berar C., Anton F. et al. The impact of 0.5% chlorhexidine oral decontamination on the prevalence of colonization and respiratory tract infection in mechanically ventilated patients. Preliminary study. Pneumologia 2013; 62(4):217-22.
  • 29. Tattawasart U., Maillard J.Y., Furr J.R., Russell A. D. Development of resistance to chlorhexidine diacetate and cetylpyridinium chloride in Pseudomonas stutzeri and changes in antibiotic susceptibility. J Hosp. Infect. 1999 Jul; 42(3):219-29.
  • 30. Randall L. P., Cooles S. W., Coldham N. G., et al. Commonly used farm disinfectants can select for mutant Salmonella enterica serovar Typhimurium with decreased susceptibility to biocides and antibiotics without compromising virulence. J Antimicrob Chemother 2007; 60:1273-80.
  • 31. Russell A. D., Tattawasart U., Maillard J-Y., Furr J. R. Possible link between bacterial resistance and use of antibiotics and biocides. Antimicrob Agents Chemother, 1998; 42:2151.
  • 32. Kõljalg S., Naaber P., Mikelsaar M. Antibiotic resistance as an indicator of bacterial chlorhexidine susceptibility. J Hosp Infect 2002; 51:106-13.
  • 33. Mah T. F., O’Toole G. A. Mechanisms of biofilm resistance to antimicrobial agents. Trends Microbiol 2001; 9 (1):34- 9.
  • 34. Ebrahimi A., Hemati M., Habibian D. S. et al. Chlorhexidine digluconate effects on planktonic growth and biofilm formation in some field isolates of animal bacterial pathogens. Jundishapur J Nat Pharm Prod 2014; 9(2):e14298.
  • 35. Wright N.E., Gilbert P. Influence of specific growth rate and nutrient limitation upon the sensitivity of Escherichia coli towards chlorhexidine diacetate. J Appl Bacteriol 1987; 62(4):309-14.
  • 36. Houari A., Di Martino P. Effect of chlorhexidine and benzalkonium chloride on bacterial biofilm formation. Lett Appl Microbiol 2007; 45(6):652-6.
  • 37. Асташкин Е. И., Карцев Н. Н., Пачкунов Д. М. и соавт. Характеристика клинических штаммов Acinetobacter baumannii. Тезисы XV Международного конгресса МАКМАХ по антимикробной терапии 22-24 мая 2013 г., Москва, Россия. КМАХ 2013; 15(2):46.
  • 38. Карцев Н. Н., Асташкин Е. И., Пачкунов Д. М. и соавт. Экстремально лекарственно-устойчивые клинические изоляты Klebsiella pneumoniae и Proteus mirabilis. Тезисы XV Международного конгресса МАКМАХ по антимикробной терапии 22-24 мая 2013 г.; Москва, Россия КМАХ 2013; 15(2):46.
  • 39. Методические указания МУК 4.2.1890-04 от 4.03.2014 г. «Определение чувствительности микроорганизмов к антибактериальным препаратам» (утв. Главным государственным санитарным врачом РФ 4 марта 2004 г.)
  • 40. Руководство 4.2.2643-10. 3.5. Дезинфектология. Методы лабораторных исследований и испытаний дезинфекционных средств для оценки их эффективности и безопасности; утв. Роспотребнадзором 01.06.2010 г.
  • 41. Kerver A. J. H., Rommes J. H., Mevissen-Verhage E. A. E., et al. Colonization and infection in surgical intensive care patients: a prospective study. Intensive Care Med 1987; 13:347-51.
  • 42. Gastmeier P., Sohr D., Geffers C., Behnke M., Rüden H. Risk factors for death due to nosocomial infection in intensive care unit patients: findings from the Krankenhaus Infektions Surveillance System. Infect Control Hosp Epidemiol 2007; 28(4):466-72.
  • 43. Dukan S., Touati D. Hypochlorous acid stress in Escherichia coli: resistance, DNA damage, and comparison with hydrogen peroxide stress. J Bacteriol 1996; 178:6145-50.
  • 44. Greenway D. L.A., England R. R. The intrinsic resistance of Escherichia coli to various antimicrobial agents requires ppGpp and σs . Lett Appl Microbiol 1999; 29:323-6.
  • 45. Høiby N., Bjarnsholt T., Givskov M., Molin S., Ciofu O. Antibiotic resistance of bacterial biofilms. Int J Antimicrob Agents 2010; 35(4):322-32.
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