Hayashi M, Kawamura K, Matsui M, Suzuki M, Suzuki S, Shibayama K, Arakawa Y
Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan.
Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan.
J Hosp Infect. 2017 Mar;95(3):318-323. doi: 10.1016/j.jhin.2016.12.004. Epub 2016 Dec 10.
Nosocomial infections caused by Acinetobacter baumannii international clone II (IC II) can cause severe clinical outcomes.
Differential evaluation of bactericidal efficacy of chlorhexidine gluconate (CHX) and benzethonium chloride (BZT) disinfectants against IC II and non-IC II isolates.
Minimum inhibitory concentrations (MICs) of CHX and BZT were determined for 137 A. baumannii IC II, 99 non-IC II and 69 non-baumannii isolates, further classified according to MIC values into disinfectant-reduced susceptible (DRS) and disinfectant-susceptible (DS) groups. Time-kill curves and minimum bactericidal concentrations (MBCs) were evaluated for representative isolates in each group.
CHX and BZT MICs for IC II isolates were 100 and 175mg/L, respectively, but those for non-IC II and non-baumannii isolates were <100mg/L. Nevertheless, time-kill curves indicated that CHX and BZT reduced live bacterial cell number by 5 log for IC II and non-IC II isolates within 30s when used at 1000mg/L, comparable to practical use concentrations. CHX MBC at 30s was 1000mg/L for IC II and non-IC II isolates, and was not influenced by addition of 3% bovine serum albumin (BSA); BZT MBC at 30s was 100mg/L without BSA and increased up to 500mg/L upon addition of BSA. No significant differences in BSA were found between DRS and DS isolates.
CHX and BZT were effective against Acinetobacter spp. including IC II at a concentration of 1000mg/L and exposure for at least 30s, but their concentrations should be considered carefully to ensure sufficient effects in both clinical and healthcare settings.
鲍曼不动杆菌国际克隆II型（IC II）引起的医院感染可导致严重的临床后果。
差异评估葡萄糖酸洗必泰（CHX）和苄索氯铵（BZT）消毒剂对IC II型和非IC II型分离株的杀菌效果。
测定了137株鲍曼不动杆菌IC II型、99株非IC II型和69株非鲍曼不动杆菌分离株对CHX和BZT的最低抑菌浓度（MIC），并根据MIC值进一步分为消毒剂低敏感（DRS）组和消毒剂敏感（DS）组。对每组中的代表性分离株进行了时间-杀菌曲线和最低杀菌浓度（MBC）评估。
IC II型分离株对CHX和BZT的MIC分别为100mg/L和175mg/L，但非IC II型和非鲍曼不动杆菌分离株的MIC均<100mg/L。然而，时间-杀菌曲线表明，当以1000mg/L使用时，CHX和BZT在30秒内可使IC II型和非IC II型分离株的活菌数减少5个对数，这与实际使用浓度相当。IC II型和非IC II型分离株在30秒时CHX的MBC为1000mg/L，且不受添加3%牛血清白蛋白（BSA）的影响；BZT在无BSA时30秒的MBC为100mg/L，添加BSA后增至500mg/L。DRS组和DS组分离株之间的BSA无显著差异。
CHX和BZT在浓度为1000mg/L且暴露至少30秒时对包括IC II型在内的不动杆菌属有效，但在临床和医疗环境中应仔细考虑其浓度以确保有足够的效果。
