title: Activity of the antiseptic polyhexanide against meticillin-susceptible and meticillin-resistant Staphylococcus aureus.
abstract: Staphylococcus aureus is one of the most important pathogens, with increasing emergence of meticillin-resistant S. aureus (MRSA) strains. This is associated not only with multiresistance to antibiotics but also with increasing resistance to topical antibiotics and antiseptics. As the antiseptic polyhexanide has only a low risk of emergence of resistant strains, the aim of the study was to obtain data on the sensitivity of S. aureus towards polyhexanide. The effect of polyhexanide was tested against 80 meticillin-susceptible S. aureus (MSSA) and 80 MRSA strains from sporadic cases as well as against 6 MRSA outbreak strains. The clonal diversity of the 166 strains was proven by pulsed-field gel electrophoresis (PFGE). Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined by the serial broth microdilution technique according to DIN 58940. Time-kill studies were performed for reference strains MSSA ATCC 29213 and MRSA ATCC 33591. MICs and MBCs in the range of 0.5-2mg/L were found. According to a created epidemiological cut-off (ECOFF) value of 4mg/L, all strains were regarded as susceptible to polyhexanide, including MRSA epidemic strains and MSSA and MRSA sporadic strains with various antibiotic susceptibility patterns. Addition of up to 4% albumin to the test medium did not change the MICs and MBCs. Time-kill studies showed reduction rates of 4log10CFU/mL for 200mg/L and 5log10CFU/mL for 400mg/L polyhexanide within 5-30min. It is concluded that polyhexanide is suitable for topical eradication of S. aureus.
authors.affiliation: Institut für Medizinische Mikrobiologie, Virologie und Krankenhaushygiene, Universität Rostock, Schillingallee 70, D-18057 Rostock, Germany. Electronic address: werner.fabry@ish.de.
authors.forename: W
authors.initials: W
authors.lastname: Fabry
authors.affiliation: 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Eppendorf, Martinistr. 52, D-20264 Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Reimer
authors.affiliation: Medizinische Klinik 2, Kardiologie, Mathias-Spital Rheine, Frankenburgstr. 31, D-48431 Rheine, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Azem
authors.affiliation: Institut für Virologie, Universitätsklinikum Gießen und Marburg, Hans-Meerwein-Str. 2, D-35043 Marburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Aepinus
authors.affiliation: Neckar-Odenwald-Kliniken, Klinik für Orthopädie und Unfallchirurgie, Knopfweg 1, D-74821 Mosbach, Germany.
authors.forename: H J
authors.initials: HJ
authors.lastname: Kock
authors.affiliation: Hartenstein Hospital Wildetal, Günter-Hartenstein-Str. 8, D-34537 Bad Wildungen-Reinhardshausen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Vahlensieck
keywords: Antiseptic; Meticillin-resistant Staphylococcus aureus; Minimum bactericidal concentration; Minimum inhibitory concentration; Polyhexanide; Staphylococcus aureus