Saturday, 6 September 2014

Are bacteria growing less susceptible to common antiseptics?

Chlorhexidine gluconate (CHG) has been increasingly used in hospitals in light of recent evidence that daily antiseptic baths for patients in intensive care units (ICUs) may prevent infections and stop the spread of healthcare-associated infections. However, the impact of this expanded use on the effectiveness of the disinfectant is not yet known.

In a recent study, investigators compared bacterial resistance between cultures from patients in eight ICUs receiving daily antiseptic washes to patients in 30 non-ICUs who did not bathe daily with CHG. Bacterial cultures obtained from patients with regular antiseptic baths showed reduced susceptibility to CHG when compared with those from patients who did not have antiseptic baths. Regardless of unit protocol, 69 percent of all bacteria showed reduced CHG susceptibility, a trend that requires vigilant monitoring.

The investigators caution that the clinical implications of their findings remain unclear. For example, antibiotic susceptibility tests are commonly used to determine whether patients will respond to antibiotic treatment. A similar correlation between antiseptic susceptibility and response to an antiseptic are not as well defined. Identifying particular bacteria and settings in which these bacteria will not respond to antiseptic agents used in hospitals is an important next step.

The reference is:

Nuntra Suwantarat, Karen C. Carroll, Tsigereda Tekle, Tracy Ross, Lisa L. Maragakis, Sara E. Cosgrove, Aaron M. Milstone. High Prevalence of Reduced Chlorhexidine Susceptibility in Organisms Causing Central Line–Associated Bloodstream Infections. Infection Control and Hospital Epidemiology, 2014; 35 (9): 1183 DOI: 10.1086/677628

Posted by Tim Sandle