Influence of whole-body washing of critically ill patients with chlorhexidine on Acinetobacter baumannii isolates

Soraya Mendoza-Olazarán, Adrian Camacho-Ortiz, Michel Fernando Martínez-Reséndez, Jorge Martín Llaca-Díaz, Edelmiro Pérez-Rodríguez, Elvira Garza-González

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)874-8
Number of pages5
JournalAmerican Journal of Infection Control
Volume42
Issue number8
DOIs
Publication statusPublished - Aug 2014
Externally publishedYes

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Acinetobacter baumannii
Chlorhexidine
Critical Illness
Microbial Sensitivity Tests
Clone Cells
Pulsed Field Gel Electrophoresis
Biofilms
Intensive Care Units
Integrons
Gentian Violet
Imipenem
Tertiary Healthcare
Baths
Tertiary Care Centers
Agar
chlorhexidine gluconate
Staining and Labeling
Asp(5)-oxytocin
Infection
Pharmaceutical Preparations

Bibliographical note

Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Cite this

Mendoza-Olazarán, Soraya ; Camacho-Ortiz, Adrian ; Martínez-Reséndez, Michel Fernando ; Llaca-Díaz, Jorge Martín ; Pérez-Rodríguez, Edelmiro ; Garza-González, Elvira. / Influence of whole-body washing of critically ill patients with chlorhexidine on Acinetobacter baumannii isolates. In: American Journal of Infection Control. 2014 ; Vol. 42, No. 8. pp. 874-8.
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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.",
author = "Soraya Mendoza-Olazar{\'a}n and Adrian Camacho-Ortiz and Mart{\'i}nez-Res{\'e}ndez, {Michel Fernando} and Llaca-D{\'i}az, {Jorge Mart{\'i}n} and Edelmiro P{\'e}rez-Rodr{\'i}guez and Elvira Garza-Gonz{\'a}lez",
note = "Copyright {\circledC} 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.",
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Mendoza-Olazarán, S, Camacho-Ortiz, A, Martínez-Reséndez, MF, Llaca-Díaz, JM, Pérez-Rodríguez, E & Garza-González, E 2014, 'Influence of whole-body washing of critically ill patients with chlorhexidine on Acinetobacter baumannii isolates', American Journal of Infection Control, vol. 42, no. 8, pp. 874-8. https://doi.org/10.1016/j.ajic.2014.04.009

Influence of whole-body washing of critically ill patients with chlorhexidine on Acinetobacter baumannii isolates. / Mendoza-Olazarán, Soraya; Camacho-Ortiz, Adrian; Martínez-Reséndez, Michel Fernando; Llaca-Díaz, Jorge Martín; Pérez-Rodríguez, Edelmiro; Garza-González, Elvira.

In: American Journal of Infection Control, Vol. 42, No. 8, 08.2014, p. 874-8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Influence of whole-body washing of critically ill patients with chlorhexidine on Acinetobacter baumannii isolates

AU - Mendoza-Olazarán, Soraya

AU - Camacho-Ortiz, Adrian

AU - Martínez-Reséndez, Michel Fernando

AU - Llaca-Díaz, Jorge Martín

AU - Pérez-Rodríguez, Edelmiro

AU - Garza-González, Elvira

N1 - Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

PY - 2014/8

Y1 - 2014/8

N2 - 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.

AB - 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.

U2 - 10.1016/j.ajic.2014.04.009

DO - 10.1016/j.ajic.2014.04.009

M3 - Article

C2 - 24913762

VL - 42

SP - 874

EP - 878

JO - American Journal of Infection Control

JF - American Journal of Infection Control

SN - 0196-6553

IS - 8

ER -