Wootton Mandy, Walsh Timothy R, Davies Eleri M, Howe Robin A
NPHS Microbiology Cardiff, University Hospital Wales, United Kingdom.
Infect Control Hosp Epidemiol. 2009 Mar;30(3):226-32. doi: 10.1086/595691.
The presence of methicillin-resistant Staphylococcus aureus (MRSA) and glycopeptide-intermediate S. aureus (GISA) in hospitals poses a significant challenge to hospital infection control teams. The use of disinfectants for both surface and hand cleaning is an essential part of the infection control measures.
To evaluate the effectiveness of common hospital hand disinfectants against MRSA, GISA, and heterogeneous GISA (hGISA).
For methicillin-susceptible S. aureus (MSSA), MRSA, GISA, and hGISA, the levels of susceptibility to hand disinfectants and their active ingredients were determined. Suspension tests were performed on commercial handwashing products.
Minimum inhibitory concentrations (MICs) of 2-propanol, chlorhexidine, and hexachlorophene were similar for all phenotypes. The MICs of cetrimide and triclosan were higher for the MRSA, GISA, and hGISA strains than for the MSSA strain. The MICs for the chlorhexidine-containing agents Hibisol and Hibiscrub (AstraZeneca) and for the propanol-containing agent Sterillium (Medline) were 1-2-fold lower for the MSSA strains than for the MRSA, GISA, and hGISA strains. Suspension tests showed that the GISA and hGISA strains were less susceptible to the triclosan-containing agent Aquasept (SSL) than were the MRSA and MSSA strains, with resistance increasing with glycopeptide resistance. Products containing Betadine (Purdue) were more effective against the GISA and hGISA strains than against the MRSA and MSSA strains, especially after the strain was exposed to the product for 30 seconds.
Using the EN 1040 standard criteria for the performance of disinfectants, we determined that all agents, except 50% Aquasept for hGISA and 0.33% hexachlorophene for GISA, performed effectively. However, the GISA and hGISA strains were less susceptible to triclosan-containing products, compared with the MRSA stains, but were more susceptible to products containing Betadine.
医院中耐甲氧西林金黄色葡萄球菌（MRSA）和糖肽中介金黄色葡萄球菌（GISA）的存在给医院感染控制团队带来了重大挑战。使用消毒剂进行表面清洁和手部清洁是感染控制措施的重要组成部分。
评估常见医院手部消毒剂对MRSA、GISA和异质性GISA（hGISA）的有效性。
测定了甲氧西林敏感金黄色葡萄球菌（MSSA）、MRSA、GISA和hGISA对手部消毒剂及其活性成分的敏感性水平。对市售洗手液产品进行了悬液试验。
所有表型的异丙醇、洗必泰和六氯酚的最低抑菌浓度（MIC）相似。与MSSA菌株相比，MRSA、GISA和hGISA菌株的西曲溴铵和三氯生的MIC更高。含洗必泰的制剂Hibisol和Hibiscrub（阿斯利康）以及含丙醇的制剂Sterillium（美迪信）对MSSA菌株的MIC比对MRSA、GISA和hGISA菌株低1至2倍。悬液试验表明，与MRSA和MSSA菌株相比，GISA和hGISA菌株对含三氯生的制剂Aquasept（SSL）的敏感性较低，且随着糖肽耐药性的增加耐药性增强。含聚维酮碘（普渡）的产品对GISA和hGISA菌株比对MRSA和MSSA菌株更有效，尤其是在菌株接触该产品30秒后。
使用EN 1040消毒剂性能标准，我们确定除了对hGISA的50% Aquasept和对GISA的0.33%六氯酚外，所有制剂均有效。然而，与MRSA菌株相比，GISA和hGISA菌株对含三氯生的产品敏感性较低，但对含聚维酮碘的产品更敏感。
