TY - JOUR
T1 - Susceptibility to chlorhexidine amongst multidrug-resistant clinical isolates of Staphylococcus epidermidis from bloodstream infections
AU - Hijazi, Karolin
AU - Mukhopadhya, Indrani
AU - Abbott, Felicity
AU - Milne, Kathleen
AU - Al-Jabri, Zaaima J.
AU - Oggioni, Marco R.
AU - Gould, Ian M.
N1 - Publisher Copyright:
© 2016 Elsevier B.V. and International Society of Chemotherapy
PY - 2016/7/1
Y1 - 2016/7/1
N2 - The emergence of Staphylococcus isolates with reduced susceptibility to chlorhexidine is being increasingly reported. We present an update to a previous report showing the continuing efficacy of chlorhexidine-based infection control measures against Staphylococcus aureus over 6 years. In this study, qacA/B genes were screened in Staphylococcus isolates collected over another 6 years in the same intensive care unit in Scotland where chlorhexidine baths form an essential component of long-term control of nosocomial infections. Consistent with our previous study, we report minimal presence of qacA/B in S. aureus strains from screening samples and bacteraemia patients but the new finding of a high proportion of qacA/B carriage in Staphylococcus epidermidis associated with reduced susceptibility to chlorhexidine. S. epidermidis isolates positive for qacA/B were clonally diverse, although 65% of isolates belonged to the multidrug-resistant (MDR) clone ST2. These findings raise concerns in relation to the selection of MDR strains by chlorhexidine and are important in the context of recent evidence emphasising the benefits of targeting bloodstream infections associated with coagulase-negative staphylococci.
AB - The emergence of Staphylococcus isolates with reduced susceptibility to chlorhexidine is being increasingly reported. We present an update to a previous report showing the continuing efficacy of chlorhexidine-based infection control measures against Staphylococcus aureus over 6 years. In this study, qacA/B genes were screened in Staphylococcus isolates collected over another 6 years in the same intensive care unit in Scotland where chlorhexidine baths form an essential component of long-term control of nosocomial infections. Consistent with our previous study, we report minimal presence of qacA/B in S. aureus strains from screening samples and bacteraemia patients but the new finding of a high proportion of qacA/B carriage in Staphylococcus epidermidis associated with reduced susceptibility to chlorhexidine. S. epidermidis isolates positive for qacA/B were clonally diverse, although 65% of isolates belonged to the multidrug-resistant (MDR) clone ST2. These findings raise concerns in relation to the selection of MDR strains by chlorhexidine and are important in the context of recent evidence emphasising the benefits of targeting bloodstream infections associated with coagulase-negative staphylococci.
KW - Chlorhexidine baths
KW - Intensive care unit
KW - Multidrug resistance
KW - Staphylococcus aureus
KW - Staphylococcus epidermidis
KW - qac genes
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U2 - 10.1016/j.ijantimicag.2016.04.015
DO - 10.1016/j.ijantimicag.2016.04.015
M3 - Article
C2 - 27230473
AN - SCOPUS:84973931554
SN - 0924-8579
VL - 48
SP - 86
EP - 90
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 1
ER -