title: Influence of whole-body washing of critically ill patients with chlorhexidine on Acinetobacter baumannii isolates.
abstract: BACKGROUND
  Acinetobacter baumannii is 1 of the most important nosocomial pathogens and the causative agent of numerous types of infections, especially in intensive care units (ICUs). Our aim was to evaluate the effect of 2% chlorhexidine gluconate (CHG) whole-body washing of ICU patients on A baumannii in a tertiary care hospital.
  
  
  METHODS
  During the 6-month intervention period, 327 patients were subjected to whole-body bath with 2% CHG-impregnated wipes. blaIMP (active on imipenem), blaVIM (Verona integron-encoded metallo-ß-lactamase), and blaoxacillinase (OXA) of A baumannii were typed. Isolates were genotyped by pulsed-field gel electrophoresis. Minimum inhibitory concentrations (MIC) to CHG were determined by the agar dilution method and drug susceptibility determined using the broth microdilution method. Biofilm formation was determined by crystal violet staining.
  
  
  RESULTS
  We analyzed 80 isolates during the baseline period and 69 isolates during the intervention period. There was a decrease in the MIC₅₀ and MIC₉₀ values for CHG for isolates (8 mg/L and 16 mg/L, respectively). All isolates typed positive for OXA₅₁-like and 86% typed positive for OXA₂₄-like pulsed-field gel electrophoresis identified 2 main clone types. During the intervention period the frequency of clone A decreased and that of clone B increased. Both clones were OXA₂₄-like positive.
  
  
  CONCLUSIONS
  The A baumannii isolates recovered from patients who received body washing with 2% CHG presented with a significant decrease in CHG MIC values associated with a change in clonality correlating with increased biofilm production.
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
authors.forename: Soraya
authors.initials: S
authors.lastname: Mendoza-Olazarán
authors.affiliation: Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autonoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
authors.forename: Adrian
authors.initials: A
authors.lastname: Camacho-Ortiz
authors.affiliation: Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autonoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
authors.forename: Michel Fernando
authors.initials: MF
authors.lastname: Martínez-Reséndez
authors.affiliation: Departamento de Patología Clínica, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
authors.forename: Jorge Martín
authors.initials: JM
authors.lastname: Llaca-Díaz
authors.affiliation: Servicio de Trasplantes, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
authors.forename: Edelmiro
authors.initials: E
authors.lastname: Pérez-Rodríguez
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico; Departamento de Patología Clínica, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico. Electronic address: elvira_garza_gzz@yahoo.com.
authors.forename: Elvira
authors.initials: E
authors.lastname: Garza-González
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D040981:Acinetobacter baumannii / Q000145:classification / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use*; D016638:Critical Illness; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D062606:Tertiary Care Centers; D055815:Young Adult; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D001618:beta-Lactamases; D002710:Chlorhexidine
keywords: Disinfectant; IMP (active on imipenem); Oxacillinase; Pulsed-field gel electrophoresis; VIM (Verona integron-encoded metallo-ß-lactamase)