Using Chlorhexidine Indiscriminately !! Can It Do More Harm Than Good ??
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 12
Abstract
Introduction-Chemical substances with antiseptic, disinfectant, and/or preservative activity have been defined as biocides. Chlorhexidine (CHX) is a biguanide compound, widely used in a clinical practice as a skin and mucous membrane antiseptic and disinfectant. However, bacterial resistance to CHX has been detected but there is a lack of simple method for routine testing of CHX susceptibility. Increasing frequency of hospital infection leads to overuse and pressure of biocides, similarly to antibiotics. The linkage between bacterial resistance and the use of biocides has been suggested. Objective- Detection of decreased CHX susceptibility of clinical isolates from different wards in association with drug resistance pattern of these isolates. Materials And Methods: The clinical isolates were isolated from various clinical samples obtained from wards and ICU. The MIC of chlorhexidine digluconate for all clinical isolates was determined as per CLSI guideline and antibiotic resistance pattern was noted. Results- Among 235 isolates 47 showed MIC of >256 g/ml and these isolates showed statistically significant (P value 0.05) association between decreased susceptibility to CHX and resistance to sulfamethoxazoletrimethoprim, cephalosporin, carbapenem, aminoglycoside, penicillin with lactamase inhibitors group of antibiotics. Thirty one isolates with MIC > 512 mg/L showed statistically significant (P value 0.05) association between decreased susceptibility to CHX and resistance to Sulfamethoxazole-trimethoprim, carbapenems and aminoglycoside group of antibiotics Conclusion- This study raises an important question whether the indiscriminate use of CHX in hospital settings might select the multi-drug resistant organisms to be the predominant flora in the hands of health care providers which in turn might be transmitted to the patient. Especially in view of the fact that biocides when used on the unclean and wet surfaces might itself promote the development of CHX resistance. Thus this study highlights the point that CHX resistance might itself trigger antibiotic resistance.
Authors and Affiliations
Simit Kumar, Maitreyi Bandyopadhyay, Subhadip Das, Manas Kumar Bandyopadhyay, Prabir Kumar Mukhopadhyay, Anindita Chatterjee, Mitali Chatterjee
Keywords
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- EP ID EP251508
- DOI 10.9790/0853-1612107478
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