Efficacy of concurrent application of chlorhexidine gluconate and povidone iodine against six nosocomial pathogens
Efficacy of concurrent application of chlorhexidine gluconate and povidone iodine against six nosocomial pathogens
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DOI：
10.1016/j.ajic.2010.06.022
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发表时间：
2010-12-01
影响因子：
4.9
通讯作者：
Peterson, Marnie L.
中科院分区：
文献类型：
--
作者：
Anderson, Michele J.;Horn, Mary E.;Peterson, Marnie L.
背景资料：葡萄糖酸氯己定（CHG）和聚维酮碘（PI）很少同时使用，尽管缺乏关于这些药物功能不相容的证据。评价CHG和PI单独和联合对金黄色葡萄球菌的作用（甲氧西林敏感金黄色葡萄球菌[MSSA]和耐甲氧西林金黄色葡萄球菌[MRSA]），表皮葡萄球菌（MRSE），鲍曼不动杆菌，铜绿假单胞菌，和大肠杆菌的检测。最小杀菌浓度（MBC）是与生长对照中的细菌密度相比，在2小时时减少细菌负荷≥ 5-log（10）菌落形成单位/mL的浓度（重量/体积百分比）。计算部分杀菌浓度指数（FBCI）以确定CHG和PI的相容性。此外，从新鲜切除的猪阴道粘膜的组织塞感染金黄色葡萄球菌（MSSA），处理2小时与CHG 3%，PI 5%，或CHG 3%和PI 5%的组合，然后对组织塞上的活菌numbered.Results：在肉汤中，CHG表现出剂量依赖性的杀菌活性，而PI活性是全或无。研究的所有分离株对CHG的敏感性相似（MBC：分别为0.0078% +/-0.0019%、0.0069% +/-0.0026%、0.0024%+/-0.0005%、0.0024% +/-0.0005%、0.0059% +/-0.0%和0.0029% +/-0.0%）。所有分离株的PI MBC相同（0.625%）。总的来说，FBCI的计算结果显示无关紧要。MSSA感染的猪组织2小时的治疗表明，CHG PI组合是上级任一防腐剂solid.Conclusion：FBCI，在肉汤培养中确定，表明结合CHG和PI防腐没有负面影响。此外，来自离体猪粘膜感染模型的数据表明，当组合2种防腐剂时具有潜在益处。
Background: Chlorhexidine gluconate (CHG) and povidone iodine (PI) are rarely used concurrently despite a lack of evidence regarding functional incompatibility of these agents.Methods: CHG and PI, alone and combined, were evaluated against Staphylococcus aureus (methicillin-suseptible S aureus [MSSA] and methicillin-resistant S aureus [MRSA]), Staphylococcus epidermidis (MRSE), Acinetobacter baumannii, Pseudomonas aeruginosa, and Escherichia coli using checkerboard microbroth dilution techniques. Minimum bactericidal concentration (MBC) was the concentration (percent wt/vol) that reduced bacterial burden >= 5-log(10) colony-forming units/mL at 2 hours when compared with bacterial densities in growth controls. Fractional bactericidal concentration indexes (FBCIs) were calculated to determine CHG and PI compatibility. Additionally, tissue plugs from freshly excised porcine vaginal mucosa were infected with S aureus (MSSA), treated for 2 hours with CHG 3%, PI 5%, or CHG 3% and PI 5% combined and then viable bacteria on the tissue plugs enumerated.Results: In broth, CHG demonstrated dose-dependent bactericidal activity, whereas PI activity was all-or-none. All isolates studied were similarly susceptible to CHG (MBCs: 0.0078% +/- 0.0019%, 0.0069% +/- 0.0026%, 0.0024% +/- 0.0005%, 0.0024% +/- 0.0005%, 0.0059% +/- 0.0%, and 0.0029% +/- 0.0%, respectively). The MBCs of PI were identical (0.625%) for all isolates. Overall, FBCI calculations showed indifference. Treatment of MSSA-infected porcine tissue for 2 hours demonstrated that the CHG-PI combination was superior to either antiseptic alone.Conclusion: FBCIs, determined in broth culture, indicate that combining CHG and PI had no negative impact on antisepsis. Moreover, data from an ex vivo porcine mucosal infection model suggest a potential benefit when combining the 2 antiseptic agents.