Chlorhexidine gluconate usage is associated with antiseptic tolerance in staphylococci from the neonatal intensive care unit.
Chlorhexidine gluconate usage is associated with antiseptic tolerance in staphylococci from the neonatal intensive care unit.
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DOI：
10.1093/jacamr/dlab173
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发表时间：
2021-12
影响因子：
3.4
通讯作者：
Webber MA
中科院分区：
文献类型：
--
作者：
Sethi DK;Felgate H;Diaz M;Faust K;Kiy C;Clarke P;Härtel C;Rupp J;Webber MA
血管内导管对于新生儿重症监护病房 (NICU) 的护理至关重要，但会使婴儿容易发生导管相关感染，包括通常由 CoNS 引起的迟发性败血症。消毒剂用于预防最常用的洗必泰 (CHG) 和奥替尼啶 (OCT) 感染。研究抗菌剂使用与细菌敏感性之间的关联。 CoNS 分离株是从两个采用不同消毒方案的 NICU 收集的：英国诺维奇（使用 CHG）和德国吕贝克（使用 OCT）。入院时以及此后每周从婴儿的不同身体部位分离 CoNS。进行了防腐剂敏感性测试，并选择进行了基因组测序。总共收集到1274个分离株。英国分离株 (n = 863) 比德国分离株 (n = 411) 对 CHG（平均 MIC：20.1mg/L 与 8.9mg/L）和 OCT（平均 MIC：2.3mg/L 与 1.6mg/L）的敏感性显着降低。入院时采集的英国分离株比后续分离株更容易受到 CHG 的影响。未发现药剂之间存在交叉耐药性。 122 个 CoNS 的基因组测序显示，最常见的物种是表皮葡萄球菌和溶血葡萄球菌，系统发育分析表明防腐剂耐受性在独立谱系中多次进化。没有证据表明存在显性抗菌剂耐受性克隆，并且携带先前与抗菌药物敏感性有关的基因（qac、smr、norA/B），与 CHG 或 OCT 敏感性无关。长期使用 CHG 可能会选择 CoNS 中的 CHG 和 OCT 耐受性。这凸显了选择单独的抗菌方案来选择耐药性发展的不同潜力。这可能是制定未来感染控制政策的重要因素。
Intravascular catheters are essential for care in Neonatal Intensive Care Units (NICUs) but predispose infants to catheter-associated infections including late-onset sepsis, commonly caused by CoNS. Antiseptics are applied to prevent infection with chlorhexidine (CHG) and octenidine (OCT) the most common agents used. To investigate the association between antiseptic use and bacterial susceptibility. CoNS isolates were collected from two NICUs with differing antiseptic regimens: Norwich, UK (using CHG) and Lubeck, Germany (using OCT). CoNS were isolated from different body sites of babies upon admission, and weekly thereafter. Antiseptic susceptibility testing was performed, and a selection underwent genome sequencing. A total of 1274 isolates were collected. UK isolates (n = 863) were significantly less susceptible than German isolates (n = 411) to both CHG (mean MIC: 20.1 mg/L versus 8.9 mg/L) and OCT (mean MIC: 2.3 mg/L versus 1.6 mg/L). UK isolates taken on admission were more susceptible to CHG than subsequent isolates. No cross-resistance between the agents was seen. Genome sequencing of 122 CoNS showed the most common species to be Staphylococcus epidermidis and Staphylococcus haemolyticus and phylogenetic analysis suggested antiseptic tolerance evolved multiple times in independent lineages. There was no evidence of dominant antiseptic tolerant clones and carriage of genes previously implicated in antimicrobial susceptibility (qac, smr, norA/B), did not correlate with CHG or OCT susceptibility. Long-term CHG use may select for CHG and OCT tolerance in CoNS. This highlights the different potential for separate antiseptic regimens to select for resistance development. This could be an important factor in developing future infection control policies.
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影响因子：
4.9
作者：
Carter GP;Ussher JE;Da Silva AG;Baines SL;Heffernan H;Riley TV;Broadbent R;van der Linden A;Lee J;Monk IR;Stinear TP;Howden BP;Williamson DA
通讯作者：
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通讯作者：
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影响因子：
6.4
作者：
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通讯作者：
Webber, Mark
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作者：
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