Leshem Tamar, Gilron Shani, Azrad Maya, Peretz Avi
Baruch Padeh Medical Center, Clinical Microbiology Laboratory, Poriya, Tiberias, 1528001, Israel.
The Azrieli Faculty of Medicine, Bar Ilan University, Safed, 1311502, Israel.
Microbes Infect. 2022 Mar;24(2):104891. doi: 10.1016/j.micinf.2021.104891. Epub 2021 Oct 8.
Chlorhexidine gluconate (CHG) is one of the most commonly used antiseptic, acting against Gram-negative, Gram-positive bacteria, yeast and fungi. However, over use may lead to reduced susceptibility of different bacteria to CHG. This study aimed to characterize the CHG susceptibility among Gram-negative strains in Israel, to evaluate factors that may affect this susceptibility, and to compare CHG susceptibility between ESBLs bacteria to strains without these enzymes. Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella spp, Escherichia coli, and Acinetobacter baumannii were isolated from clinical samples of 193 patients hospitalized at Padeh-Poriya Medical Center. Phenotypic CHG susceptibility was assessed by determining minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The highest CHG MIC was found among P. mirabilis. The differences between the CHG MIC values among the different strains were statistically significant (p < 0.001). ESBL-positive strains had higher MIC values as compared to ESBL-negative strains (p = 0.030). A significant association was found between CHG susceptibility and sample source (p = 0.015). In conclusion, the information gathered here significantly improves our knowledge on the reduced susceptibility to CHG among Gram-negative bacteria in Israel. Moreover, ESBL-positive bacteria are less susceptible to CHG and finally, bacteria in sputum, wounds, and body fluids are less CHG-susceptible.
葡萄糖酸氯己定（CHG）是最常用的防腐剂之一，可对抗革兰氏阴性菌、革兰氏阳性菌、酵母和真菌。然而，过度使用可能会导致不同细菌对CHG的敏感性降低。本研究旨在描述以色列革兰氏阴性菌株对CHG的敏感性特征，评估可能影响这种敏感性的因素，并比较产超广谱β-内酰胺酶（ESBLs）细菌与不产这些酶的菌株对CHG的敏感性。从帕德-波里亚医疗中心住院的193例患者的临床样本中分离出铜绿假单胞菌、奇异变形杆菌、克雷伯菌属、大肠埃希菌和鲍曼不动杆菌。通过测定最低抑菌浓度（MIC）和最低杀菌浓度（MBC）来评估CHG的表型敏感性。在奇异变形杆菌中发现了最高的CHG MIC。不同菌株之间的CHG MIC值差异具有统计学意义（p < 0.001）。与ESBL阴性菌株相比，ESBL阳性菌株的MIC值更高（p = 0.030）。发现CHG敏感性与样本来源之间存在显著关联（p = 0.015）。总之，此处收集的信息显著提高了我们对以色列革兰氏阴性菌对CHG敏感性降低的认识。此外，ESBL阳性细菌对CHG的敏感性较低，最后，痰液、伤口和体液中的细菌对CHG的敏感性较低。
