The Effect of Brief Exposure to Sub-Therapeutic Concentrations of Chlorhexidine Digluconate on the Susceptibility of Staphylococci to Platelet Microbicidal Protein

IvanovIuri, B; Гриценко, В. А.; KuzminMichael, D

doi:10.1089/sur.2013.173

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…It may be related, in whole or part, to the bacteriocidal effects that chlorhexidine offers, but requires further investigation. 8 An important exception to the above is a randomized study by Storey et al 20 that found no statistically significant difference in incidence of CLABSI with impregnated PICCS relative to plain/uncoated PICCs. However, this study was unblinded and underpowered: out of 167 line insertions only three CLABSI occurred.…”

Section: Discussionmentioning

confidence: 96%

“…1,4,5 Introduction of a PICC into a vein also triggers a series of pathophysiological interactions, including activation of contact and complement factors, platelet activation, and leukocyte adhesion at the venous intima and the luminal and non-luminal surfaces of the PICC, creating a potential opportunity for both CLABSI and thrombosis development, where progression of one of these phenomena could possibly promote the progression of the other. 8,9,[22][23][24] Clinical studies have demonstrated impactful microbial colonization reduction with use of chlorhexidine-coated PICCs, 19,20 It has also been demonstrated in animal studies catheter impregnation with chlorhexidine may reduce FS accumulation and reduces rates of catheter occlusion. Sylvia et al 12 examined the use of a chlorhexidine-coated PICC and demonstrated a reduction in FS weight (64%) and length (66%) when compared to plain/uncoated PICCs in an ovine model, even though such difference was found to be not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 An important technical innovation which mitigates the risk of catheter colonization, a major precursor to infection, is the impregnation of catheters with chlorhexidine, a broadspectrum biocide, which in addition to being bacteriostatic and bactericidal, has a direct thrombin inhibitor effect. 8 Centrally inserted central catheters (CICCs) impregnated with chlorhexidine, first introduced in 1990, have since shown in numerous clinical studies, to significantly reduce microbial colonization, a precursor to CLABSI. [9][10][11] A chlorhexidine-coated PICC (Arrowg+ard ® Blue Advance ® PICC, Arrow International, Morrisville, NC, referred to as "AGBA-PICC" hereafter), obtained Food and Drug Administration (FDA) 510(k) clearance for human use in 2011.…”

Section: Introductionmentioning

confidence: 99%

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Clinical experience with a chlorhexidine-coated PICC: A prospective, multicenter, observational study

Winkler

Spencer²,

Siddiqi

et al. 2021

J Vasc Access

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Introduction: This study evaluated a chlorhexidine-coated peripherally inserted central catheter (PICC) and the incidence of associated complications within both inpatient and outpatient populations. Methods: This IRB-approved, multicenter, prospective observational study was performed at three large teaching hospitals in the US. All adults who required a PICC for ⩾14 days were considered. Patients were monitored throughout entire catheter dwell. Duplex venous ultrasounds were performed before insertion, after 10 to 14 days of dwell time, and upon removal. Data was collected from the hospital, outpatient clinic, and patient PICC diary records. Results: A total of 103 patients, 56% male, with mean BMI 29 ± 8.8, were enrolled. The majority (79%) of patients were from high-risk groups—cancer, infectious diseases, transplant, and trauma. Primary treatment indications were antibiotics (66.99%) and chemotherapy (25.24%). Double lumen PICCs (59.2%) were favored clinically, as was basilic vein placement (71.84%). Mean catheter dwell was 47.01 ± 25.82 days. Three (3, 2.9%) central line-associated bloodstream infections (CLABSI) were reported. Four patients (4.6%) reported symptomatic catheter-related thrombosis (CRT), confirmed with ultrasound. Three patients (3.4%) had ultrasound-confirmed fibroblastic sleeve (FS). Eight patients (9.2%) who entered the study with pre-existing superficial thrombosis, had complete resolution at the time of catheter removal. The incidence of CLABSI was 0.82/1000 days. The combined CRT and FS rate was 6.9%. Conclusion: Based upon the observational findings of this study, chlorhexidine-coated PICC technology may be considered for use in patient populations who are at moderate to high-risk for catheter-related complications in both inpatient and outpatient settings.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical experience with a chlorhexidine-coated PICC: A prospective, multicenter, observational study

Winkler

Spencer²,

Siddiqi

et al. 2021

J Vasc Access

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“…In clinical settings, there are reports of pathogens which have shown decreased susceptibility to antiseptics. 15 - 17 Although such bacterial resistance against disinfectants in clinical settings are a major cause for nosocomial infections, their transference to either private of public swimming pools will be cause for public health concern. 18 Also, as diseases resulting from infections caused by S aureus, E coli, Clostridium perfringens , and Enterococcus faecalis , which had been isolated from different depths of pools by Saberianpour et al, 5 there is the possibility of transference of clinical-resistant genes to bacteria in communities through swimming pools.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Microbiological Content of Private and Public Recreational Water Facilities and Their Antimicrobial Susceptibility Pattern in Al-Ahsa

AlTuraifi

AlMomatin

Badger-Emeka

et al. 2019

Environ�Health�Insights

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Background: Water recreational facilities like swimming pools attract people of all ages. However, these facilities are very suitable for the transmission of various microbial diseases and have been shown to pose public health concerns. Aims: This study assesses the presence of different Gram-negative bacteria pathogens and their antimicrobial susceptibility pattern in both private and public pools in Al-Ahsa. Methods: 11 private and 3 public recreational water facilities were sampled for the study. Collected water samples were inoculated into nutrient broth and incubated aerobically for 24 hours. The overnight growth was plated out on blood and MacConkey agars. Pure cultures of the bacteria samples were used for identification and antimicrobial susceptibility test using the Vitek 2 compactautomated system (BioMerieux, Marcy L’Etoile, France). Minimum inhibitory concentration was also provided by the Vitek 2 compact automated system. Results: 13 different Gram-negative bacteria species isolates were encountered in both pool types sampled. More of potential pathogens were isolated from the private than the public pools, of which Klebsiella pneumoniae and Pseudomonas aeruginosa constituted 50% and 43%, respectively, of all the isolates. Findings also revealed a varied minimum inhibitory concentrations (MICs) indicating that the isolates were of different strains. Antibiotic susceptibility pattern also showed variability among the isolates. Conclusions: This study has revealed a potential health risk associated with the use of water recreational facilities. The presence of K pneumoniae and P aeruginosa suggests a public health concern and should be looked into.

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“…However, a large number of pathogens with the decreased antiseptic susceptibility have been isolated from clinical samples which showed an increased minimal inhibitory concentration (MIC) against those antiseptics. 4 , 5 , 6 , 7 , 8 These resistant pathogens are the major causes for nosocomial cross-infections in hospital. Sometimes, the infection is fatal.…”

Section: Introductionmentioning

confidence: 99%

A novel method to detect bacterial resistance to disinfectants

Zhang

Cao

et al. 2017

Genes & Diseases

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In clinical practice, the important hygienic prevention of bacterial pathogen spread is disinfection of potentially contaminated area. Benzalkonium bromide and chlorhexidine acetate are commonly used disinfectants with a broad spectrum of anti-microbial effect. It is vital to inhibit the spread of pathogen in hospital. However, a large number of pathogens with the decreased antiseptic susceptibility have been isolated from clinical samples which showed an increased minimal inhibitory concentration (MIC) against those antiseptics. These resistant pathogens are the major causes for nosocomial cross-infections in hospital. The present study demonstrated the utility of Oxford plate assay system in determining the potential disinfectant resistance of bacteria. The microbiological assay is based on the inhibitory effect of tested disinfectants upon the strains of Staphylococcus aureus and Escherichia coli. Statistical analysis of the bioassay results indicated the linear correlation (r = 0.87–0.99, P < 0.01) between the diameter of growth inhibition zone and the log dosage of the tested disinfectants. Moreover, comparison of inhibitory efficacy of benzalkonium bromide upon 29 S. aureus strains isolated from clinical samples by both Oxford plate method and broth dilution method showed that the diameter of growth inhibition zone has significantly negative correlation with the minimal inhibitory concentration (MIC) (r = −0.574, P < 0.001). These results suggest that the Oxford plate is a simple and time-saving method in detecting potential clinical disinfectant resistance and its usefulness for routine surveillance of pathogenic resistance to disinfectants warrants further investigation.

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The Effect of Brief Exposure to Sub-Therapeutic Concentrations of Chlorhexidine Digluconate on the Susceptibility of Staphylococci to Platelet Microbicidal Protein

Cited by 3 publications

References 22 publications

Clinical experience with a chlorhexidine-coated PICC: A prospective, multicenter, observational study

Clinical experience with a chlorhexidine-coated PICC: A prospective, multicenter, observational study

Assessment of Microbiological Content of Private and Public Recreational Water Facilities and Their Antimicrobial Susceptibility Pattern in Al-Ahsa

A novel method to detect bacterial resistance to disinfectants

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