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Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites

Chlorhexidine bathing to prevent transmission of multidrug-resistant organisms has been adopted by many U.S. hospitals, but increasing chlorhexidine use has raised concerns about possible emergence of resistance. We sought to establish a broth microdilution method for determining chlorhexidine MICs...

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Autores principales: Lutgring, Joseph D., Grass, Julian E., Lonsway, David, Yoo, Brian B., Epson, Erin, Crumpler, Megan, Galliher, Karen, O’Donnell, Kathleen, Zahn, Matthew, Evans, Eric, Jacob, Jesse T., Page, Alexander, Satola, Sarah W., Smith, Gillian, Kainer, Marion, Muleta, Daniel, Wilson, Christopher D., Hayden, Mary K., Reddy, Sujan, Elkins, Christopher A., Rasheed, J. Kamile, Karlsson, Maria, Magill, Shelley S., Guh, Alice Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10269762/
https://www.ncbi.nlm.nih.gov/pubmed/37067448
http://dx.doi.org/10.1128/spectrum.04134-22
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author Lutgring, Joseph D.
Grass, Julian E.
Lonsway, David
Yoo, Brian B.
Epson, Erin
Crumpler, Megan
Galliher, Karen
O’Donnell, Kathleen
Zahn, Matthew
Evans, Eric
Jacob, Jesse T.
Page, Alexander
Satola, Sarah W.
Smith, Gillian
Kainer, Marion
Muleta, Daniel
Wilson, Christopher D.
Hayden, Mary K.
Reddy, Sujan
Elkins, Christopher A.
Rasheed, J. Kamile
Karlsson, Maria
Magill, Shelley S.
Guh, Alice Y.
author_facet Lutgring, Joseph D.
Grass, Julian E.
Lonsway, David
Yoo, Brian B.
Epson, Erin
Crumpler, Megan
Galliher, Karen
O’Donnell, Kathleen
Zahn, Matthew
Evans, Eric
Jacob, Jesse T.
Page, Alexander
Satola, Sarah W.
Smith, Gillian
Kainer, Marion
Muleta, Daniel
Wilson, Christopher D.
Hayden, Mary K.
Reddy, Sujan
Elkins, Christopher A.
Rasheed, J. Kamile
Karlsson, Maria
Magill, Shelley S.
Guh, Alice Y.
author_sort Lutgring, Joseph D.
collection PubMed
description Chlorhexidine bathing to prevent transmission of multidrug-resistant organisms has been adopted by many U.S. hospitals, but increasing chlorhexidine use has raised concerns about possible emergence of resistance. We sought to establish a broth microdilution method for determining chlorhexidine MICs and then used the method to evaluate chlorhexidine MICs for bacteria that can cause health care-associated infections. We adapted a broth microdilution method for determining chlorhexidine MICs, poured panels, established quality control ranges, and tested Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae complex isolates collected at three U.S. sites. Chlorhexidine MICs were determined for 535 isolates including 129 S. aureus, 156 E. coli, 142 K. pneumoniae, and 108 E. cloacae complex isolates. The respective MIC distributions for each species ranged from 1 to 8 mg/L (MIC(50) = 2 mg/L and MIC(90) = 4 mg/L), 1 to 64 mg/L (MIC(50) = 2 mg/L and MIC(90) = 4 mg/L), 4 to 64 mg/L (MIC(50) = 16 mg/L and MIC(90) = 32 mg/L), and 1 to >64 mg/L (MIC(50) = 16 mg/L and MIC(90) = 64 mg/L). We successfully adapted a broth microdilution procedure that several laboratories were able to use to determine the chlorhexidine MICs of bacterial isolates. This method could be used to investigate whether chlorhexidine MICs are increasing. IMPORTANCE Chlorhexidine bathing to prevent transmission of multidrug-resistant organisms and reduce health care-associated infections has been adopted by many hospitals. There is concern about the possible unintended consequences of using this agent widely. One possible unintended consequence is decreased susceptibility to chlorhexidine, but there are not readily available methods to perform this evaluation. We developed a method for chlorhexidine MIC testing that can be used to evaluate for possible unintended consequences.
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spelling pubmed-102697622023-06-16 Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites Lutgring, Joseph D. Grass, Julian E. Lonsway, David Yoo, Brian B. Epson, Erin Crumpler, Megan Galliher, Karen O’Donnell, Kathleen Zahn, Matthew Evans, Eric Jacob, Jesse T. Page, Alexander Satola, Sarah W. Smith, Gillian Kainer, Marion Muleta, Daniel Wilson, Christopher D. Hayden, Mary K. Reddy, Sujan Elkins, Christopher A. Rasheed, J. Kamile Karlsson, Maria Magill, Shelley S. Guh, Alice Y. Microbiol Spectr Research Article Chlorhexidine bathing to prevent transmission of multidrug-resistant organisms has been adopted by many U.S. hospitals, but increasing chlorhexidine use has raised concerns about possible emergence of resistance. We sought to establish a broth microdilution method for determining chlorhexidine MICs and then used the method to evaluate chlorhexidine MICs for bacteria that can cause health care-associated infections. We adapted a broth microdilution method for determining chlorhexidine MICs, poured panels, established quality control ranges, and tested Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae complex isolates collected at three U.S. sites. Chlorhexidine MICs were determined for 535 isolates including 129 S. aureus, 156 E. coli, 142 K. pneumoniae, and 108 E. cloacae complex isolates. The respective MIC distributions for each species ranged from 1 to 8 mg/L (MIC(50) = 2 mg/L and MIC(90) = 4 mg/L), 1 to 64 mg/L (MIC(50) = 2 mg/L and MIC(90) = 4 mg/L), 4 to 64 mg/L (MIC(50) = 16 mg/L and MIC(90) = 32 mg/L), and 1 to >64 mg/L (MIC(50) = 16 mg/L and MIC(90) = 64 mg/L). We successfully adapted a broth microdilution procedure that several laboratories were able to use to determine the chlorhexidine MICs of bacterial isolates. This method could be used to investigate whether chlorhexidine MICs are increasing. IMPORTANCE Chlorhexidine bathing to prevent transmission of multidrug-resistant organisms and reduce health care-associated infections has been adopted by many hospitals. There is concern about the possible unintended consequences of using this agent widely. One possible unintended consequence is decreased susceptibility to chlorhexidine, but there are not readily available methods to perform this evaluation. We developed a method for chlorhexidine MIC testing that can be used to evaluate for possible unintended consequences. American Society for Microbiology 2023-04-17 /pmc/articles/PMC10269762/ /pubmed/37067448 http://dx.doi.org/10.1128/spectrum.04134-22 Text en https://doi.org/10.1128/AuthorWarrantyLicense.v1This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply.
spellingShingle Research Article
Lutgring, Joseph D.
Grass, Julian E.
Lonsway, David
Yoo, Brian B.
Epson, Erin
Crumpler, Megan
Galliher, Karen
O’Donnell, Kathleen
Zahn, Matthew
Evans, Eric
Jacob, Jesse T.
Page, Alexander
Satola, Sarah W.
Smith, Gillian
Kainer, Marion
Muleta, Daniel
Wilson, Christopher D.
Hayden, Mary K.
Reddy, Sujan
Elkins, Christopher A.
Rasheed, J. Kamile
Karlsson, Maria
Magill, Shelley S.
Guh, Alice Y.
Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites
title Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites
title_full Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites
title_fullStr Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites
title_full_unstemmed Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites
title_short Development of a Broth Microdilution Method To Characterize Chlorhexidine MICs among Bacteria Collected from 2005 to 2019 at Three U.S. Sites
title_sort development of a broth microdilution method to characterize chlorhexidine mics among bacteria collected from 2005 to 2019 at three u.s. sites
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10269762/
https://www.ncbi.nlm.nih.gov/pubmed/37067448
http://dx.doi.org/10.1128/spectrum.04134-22
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