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Report: Bacteria Growing Less Susceptible to Common Hospital Antiseptic

CHG may be losing its punch, authors say

Bacteria that cause life-threatening bloodstream infections in critically ill patients may be growing increasingly resistant to a common hospital antiseptic, according to a recent study led by investigators at Johns Hopkins. The study was published in the September issue of Infection Control and Hospital Epidemiology.

Chlorhexidine gluconate (CHG) has been increasingly used in hospitals in light of recent evidence that daily antiseptic baths for patients in intensive care units (ICUs) may prevent infections and stop the spread of health care-associated infections. The impact of this expanded use on the effectiveness of the disinfectant is not yet known.

“Hospitals are appropriately using chlorhexidine to reduce infections and to control the spread of antibiotic-resistant organisms,” said lead author Nuntra Suwantarat, MD. “However, our findings are a clear signal that we must continue to monitor bacteria for emerging antiseptic resistance as these antibacterial washes become more widely used in hospitals.”

In the study, the investigators compared bacterial resistance between cultures from patients in eight ICUs who were receiving daily antiseptic washes and patients in 30 non-ICUs who did not bathe daily with CHG. Bacterial cultures obtained from patients with regular antiseptic baths showed reduced susceptibility to CHG compared with cultures from patients who did not have antiseptic baths. Regardless of unit protocol, 69% of all bacteria showed reduced CHG susceptibility.

“The good news is that most bacteria remain vulnerable to CHG, despite the reduced susceptibility. Daily baths with a CHG solution remain effective against life-threatening bloodstream infections,” Suwantarat said.

The investigators caution that the clinical implications of their findings remain unclear. For example, antibiotic susceptibility tests are commonly used to determine whether patients will respond to antibiotic treatment. A similar correlation between antiseptic susceptibility and the response to an antiseptic is not so well defined. Identifying specific bacteria and settings in which these bacteria will not respond to antiseptic agents used in hospitals is an important next step.

Sources: SHEA; August 13, 2014; and ICHE; September 2014.

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