Klassert Tilman E, Zubiria-Barrera Cristina, Denkel Luisa A, Lopez Mercedes, Neubert Robert, Keles Slevogt Amelya, Bloos Frank, Schulze P Christian, Epstude Jörg, Gastmeier Petra, Geffers Christine, Slevogt Hortense
Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, German Center for Lung Research (DZL), BREATH, Hannover, Germany.
Dynamics of Respiratory Infections Group, Helmholtz Centre for Infection Research- HZI, Inhoffenstraße 7, 38124, Braunschweig, Germany.
Med Microbiol Immunol. 2025 Jul 22;214(1):34. doi: 10.1007/s00430-025-00843-1.
Bathing strategies with antiseptic agents, such as Chlorhexidine and Octenidine, have been widely adopted to mitigate infection risks in intensive care units (ICU). However, concerns exist regarding their long-term effects on skin microbiome structures and potential unintended consequences, including antibiotic cross-resistance. This longitudinal study characterized the compositional changes of the skin microbiome of ICU patients upon these two antiseptic bathing strategies when compared to standard water and soap bathing. Samples were collected in a three-armed cluster randomized decolonization trial (registration number DRKS00010475). Skin swabs from 5 different sites and three time points were analyzed by culture-based methods, 16S rRNA-gene amplicon sequencing and multiplex Taq-Man assays for detection of antimicrobial resistance genes (ARG). Our results show that Chlorhexidine bathing led to a sustained reduction of the bacterial biomass on different skin sites, as measured by both molecular and culture-based methods. Thereby, the microbial structures remained largely unaltered both in their diversity and their taxonomic composition. However, the loss of microbiome site-specificity observed on the skin of ICU patients remained unchanged independently from the bathing strategy applied and persisted even after discharge. None of the antiseptic bathing strategies led to an increase or accumulation of antibiotic-resistance determinants on any of the skin sites investigated in this study. Thus, this study suggests that daily patient bathing with 2% Chlorhexidine impregnated cloths or 0.08% Octenidine wash mitts does not impact skin microbiome structures and antibiotic resistance gene accumulation in ICU patients when compared to non-antiseptic water and soap bathing routine.
使用洗必泰（氯己定）和奥替尼啶等抗菌剂的沐浴策略已被广泛采用，以降低重症监护病房（ICU）的感染风险。然而，人们担心它们对皮肤微生物群结构的长期影响以及潜在的意外后果，包括抗生素交叉耐药性。这项纵向研究对这两种抗菌沐浴策略下ICU患者皮肤微生物群的组成变化进行了特征分析，并与标准的清水和肥皂沐浴进行了比较。样本是在一项三臂整群随机去定植试验（注册号DRKS00010475）中收集的。通过基于培养的方法、16S rRNA基因扩增子测序和多重Taq-Man分析对来自5个不同部位和三个时间点的皮肤拭子进行分析，以检测抗菌抗性基因（ARG）。我们的结果表明，通过分子方法和基于培养的方法测量，洗必泰沐浴导致不同皮肤部位的细菌生物量持续减少。因此，微生物结构在多样性和分类组成方面基本保持不变。然而，在ICU患者皮肤上观察到的微生物群部位特异性丧失与所采用的沐浴策略无关，并且在出院后仍然存在。在本研究调查的任何皮肤部位，没有一种抗菌沐浴策略导致抗生素抗性决定因素的增加或积累。因此，这项研究表明，与非抗菌的清水和肥皂沐浴常规相比，每天用含2%洗必泰的布或含0.08%奥替尼啶的洗手手套给患者沐浴不会影响ICU患者的皮肤微生物群结构和抗生素抗性基因积累。
