Disinfection Strategies for Carbapenem-Resistant Klebsiella pneumoniae in a Healthcare Facility

Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common a...

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Published inAntibiotics (Basel) Vol. 11; no. 6; p. 736
Main Authors Ni, Lijia, Zhang, Zhixian, Shen, Rui, Liu, Xiaoqiang, Li, Xuexue, Chen, Baiji, Wu, Xiquan, Li, Hongyu, Xie, Xiaoying, Huang, Songyin
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 30.05.2022
MDPI
Subjects
Antibiotics
Antimicrobial agents
Antiseptics
Bacteria
carbapenem-resistant Klebsiella pneumoniae
Cell division
Chlorhexidine
Chlorine
Departments
Dilution
disinfectant resistance
Disinfectants
Disinfection
Disinfection & disinfectants
Efflux
efflux pump
Genes
Health care
Health care facilities
Hydrogen peroxide
Infections
Klebsiella
Klebsiella pneumoniae
Laboratories
Minimum inhibitory concentration
Multidrug resistance
Neurosurgery
Nosocomial infection
France
China
efflux pump
carbapenem-resistant Klebsiella pneumoniae
disinfectant resistance
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Abstract Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common and difficult pathogens of nosocomial infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests of seven kinds of disinfectants (0.1% benzalkonium bromide, 4% aqueous chlorhexidine, 75% alcohol, entoiodine II, 2% glutaraldehyde, 2000 mg/L chlorine-containing disinfectants, and 3% hydrogen peroxide) were detected by the broth dilution method. Three efflux pump genes (oqxA, oqxB, and qacE∆1-sul1) were detected by PCR. The mean MIC value of aqueous chlorhexidine from the intensive care unit (ICU) (0.0034%) was significantly higher than that from non-ICUs (0.0019%) (p < 0.05). The positive rates of three efflux pump genes oqxA, oqxB and qacE∆1-sul1 were 60.9% (39/64), 17.2% (11/64) and 71.9% (46/64) in the detected CRKP isolates, respectively. This study discovered that CRKP strains demonstrated extensive resistance to clinical disinfectants and suggest that it is necessary to perform corresponding increases in the concentration of aqueous chlorhexidine and chlorine-containing disinfectants on the basis of current standards in the healthcare industry.
AbstractList Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common and difficult pathogens of nosocomial infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests of seven kinds of disinfectants (0.1% benzalkonium bromide, 4% aqueous chlorhexidine, 75% alcohol, entoiodine II, 2% glutaraldehyde, 2000 mg/L chlorine-containing disinfectants, and 3% hydrogen peroxide) were detected by the broth dilution method. Three efflux pump genes ( oqxA , oqxB , and qacE ∆ 1-sul1 ) were detected by PCR. The mean MIC value of aqueous chlorhexidine from the intensive care unit (ICU) (0.0034%) was significantly higher than that from non-ICUs (0.0019%) ( p < 0.05). The positive rates of three efflux pump genes oqxA , oqxB and qacE ∆ 1-sul1 were 60.9% (39/64), 17.2% (11/64) and 71.9% (46/64) in the detected CRKP isolates, respectively. This study discovered that CRKP strains demonstrated extensive resistance to clinical disinfectants and suggest that it is necessary to perform corresponding increases in the concentration of aqueous chlorhexidine and chlorine-containing disinfectants on the basis of current standards in the healthcare industry.
Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common and difficult pathogens of nosocomial infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests of seven kinds of disinfectants (0.1% benzalkonium bromide, 4% aqueous chlorhexidine, 75% alcohol, entoiodine II, 2% glutaraldehyde, 2000 mg/L chlorine-containing disinfectants, and 3% hydrogen peroxide) were detected by the broth dilution method. Three efflux pump genes (oqxA, oqxB, and qacE∆1-sul1) were detected by PCR. The mean MIC value of aqueous chlorhexidine from the intensive care unit (ICU) (0.0034%) was significantly higher than that from non-ICUs (0.0019%) (p < 0.05). The positive rates of three efflux pump genes oqxA, oqxB and qacE∆1-sul1 were 60.9% (39/64), 17.2% (11/64) and 71.9% (46/64) in the detected CRKP isolates, respectively. This study discovered that CRKP strains demonstrated extensive resistance to clinical disinfectants and suggest that it is necessary to perform corresponding increases in the concentration of aqueous chlorhexidine and chlorine-containing disinfectants on the basis of current standards in the healthcare industry.
Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common and difficult pathogens of nosocomial infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests of seven kinds of disinfectants (0.1% benzalkonium bromide, 4% aqueous chlorhexidine, 75% alcohol, entoiodine II, 2% glutaraldehyde, 2000 mg/L chlorine-containing disinfectants, and 3% hydrogen peroxide) were detected by the broth dilution method. Three efflux pump genes (oqxA, oqxB, and qacE∆1-sul1) were detected by PCR. The mean MIC value of aqueous chlorhexidine from the intensive care unit (ICU) (0.0034%) was significantly higher than that from non-ICUs (0.0019%) (p < 0.05). The positive rates of three efflux pump genes oqxA, oqxB and qacE∆1-sul1 were 60.9% (39/64), 17.2% (11/64) and 71.9% (46/64) in the detected CRKP isolates, respectively. This study discovered that CRKP strains demonstrated extensive resistance to clinical disinfectants and suggest that it is necessary to perform corresponding increases in the concentration of aqueous chlorhexidine and chlorine-containing disinfectants on the basis of current standards in the healthcare industry.Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital infection control. As a notorious multidrug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most common and difficult pathogens of nosocomial infection. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests of seven kinds of disinfectants (0.1% benzalkonium bromide, 4% aqueous chlorhexidine, 75% alcohol, entoiodine II, 2% glutaraldehyde, 2000 mg/L chlorine-containing disinfectants, and 3% hydrogen peroxide) were detected by the broth dilution method. Three efflux pump genes (oqxA, oqxB, and qacE∆1-sul1) were detected by PCR. The mean MIC value of aqueous chlorhexidine from the intensive care unit (ICU) (0.0034%) was significantly higher than that from non-ICUs (0.0019%) (p < 0.05). The positive rates of three efflux pump genes oqxA, oqxB and qacE∆1-sul1 were 60.9% (39/64), 17.2% (11/64) and 71.9% (46/64) in the detected CRKP isolates, respectively. This study discovered that CRKP strains demonstrated extensive resistance to clinical disinfectants and suggest that it is necessary to perform corresponding increases in the concentration of aqueous chlorhexidine and chlorine-containing disinfectants on the basis of current standards in the healthcare industry.
Author Huang, Songyin
Liu, Xiaoqiang
Ni, Lijia
Shen, Rui
Li, Xuexue
Chen, Baiji
Wu, Xiquan
Li, Hongyu
Zhang, Zhixian
Xie, Xiaoying
AuthorAffiliation 3 Biotherapy Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
1 Department of Clinical Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; nilj@mail.sysu.edu.cn (L.N.); zhangzhx6@mail.sysu.edu.cn (Z.Z.); shenr6@mail.sysu.edu.cn (R.S.); lxqiang@mail.sysu.edu.cn (X.L.); lixx228@mail.sysu.edu.cn (X.L.); chenbj26@mail.sysu.edu.cn (B.C.); wuxiquan@mail.sysu.edu.cn (X.W.); lehyu@126.com (H.L.)
2 Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
AuthorAffiliation_xml – name: 1 Department of Clinical Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; nilj@mail.sysu.edu.cn (L.N.); zhangzhx6@mail.sysu.edu.cn (Z.Z.); shenr6@mail.sysu.edu.cn (R.S.); lxqiang@mail.sysu.edu.cn (X.L.); lixx228@mail.sysu.edu.cn (X.L.); chenbj26@mail.sysu.edu.cn (B.C.); wuxiquan@mail.sysu.edu.cn (X.W.); lehyu@126.com (H.L.)
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Keywords efflux pump
carbapenem-resistant Klebsiella pneumoniae
disinfectant resistance
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Snippet Disinfectant resistance is evolving into a serious problem due to the long-term and extensive use of disinfectants, which brings great challenges to hospital...
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SubjectTerms Antibiotics
Antimicrobial agents
Antiseptics
Bacteria
carbapenem-resistant Klebsiella pneumoniae
Cell division
Chlorhexidine
Chlorine
Departments
Dilution
disinfectant resistance
Disinfectants
Disinfection
Disinfection & disinfectants
Efflux
efflux pump
Genes
Health care
Health care facilities
Hydrogen peroxide
Infections
Klebsiella
Klebsiella pneumoniae
Laboratories
Minimum inhibitory concentration
Multidrug resistance
Neurosurgery
Nosocomial infection
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Title Disinfection Strategies for Carbapenem-Resistant Klebsiella pneumoniae in a Healthcare Facility
URI https://www.ncbi.nlm.nih.gov/pubmed/35740143
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