title: Reduced susceptibility to chlorhexidine disinfectant among New Delhi metallo-beta-lactamase-1 positive Enterobacteriaceae and other multidrug-resistant organisms: Report from a tertiary care hospital in Karachi, Pakistan.
abstract: We analysed susceptibility of multidrug-resistant organisms (MDROs) including New Delhi metallo-beta-lactamase-1 positive Enterobacteriaceae to chlorhexidine and compared results to their susceptible counterparts. Susceptibilities of chlorhexidine digluconate in a standard (CHX-S) preparation and two commercial disinfectants containing different CHX concentrations (2% w/v and 4% w/w) were performed. MDROs had narrower range of higher CHX-S minimum inhibitory concentrations (MICs) as compared to pan-sensitive organisms. The MIC values for commercial disinfectants products for MDROs were many folds higher (20-600 times), than CHX-S for in vitro use. Increasing antibiotic resistance among bacterial isolates can be an indirect marker of reduced susceptibility to chlorhexidine in hospital setting.
authors: Department of Pathology and Laboratory Medicine, Section of Clinical Microbiology, Aga Khan University, Karachi - 74800, Pakistan.
authors: P B
authors: PB
authors: Mal
authors: Department of Pathology and Laboratory Medicine, Section of Clinical Microbiology, Aga Khan University, Karachi - 74800, Pakistan.
authors: J
authors: J
authors: Farooqi
authors: Department of Pathology and Laboratory Medicine, Section of Clinical Microbiology, Aga Khan University, Karachi - 74800, Pakistan.
authors: S
authors: S
authors: Irfan
authors: Department of Medicine, Division of Infectious Diseases, University of Virginia 22908, USA.
authors: M A
authors: MA
authors: Hughes
authors: Department of Pathology and Laboratory Medicine, Section of Clinical Microbiology, Aga Khan University, Karachi - 74800, Pakistan.
authors: E
authors: E
authors: Khan
mesh_terms: D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D002710:Chlorhexidine / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D010154:Pakistan; D062606:Tertiary Care Centers; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000891:Anti-Infective Agents, Local; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1; D002710:Chlorhexidine