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Evaluation of the Effectiveness of Common Hospital Hand Disinfectants Against Methicillin-Resistant Staphylococcus aureus, Glycopeptide-Intermediate S. aureus, and Heterogeneous Glycopeptide-Intermediate S. aureus

Published online by Cambridge University Press:  02 January 2015

Mandy Wootton ,
Timothy R. Walsh ,
Eleri M. Davies  and
Robin A. Howe
Mandy Wootton*
Affiliation:
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff, United Kingdom
Timothy R. Walsh
Affiliation:
Department of Medical Microbiology, Cardiff University, Heath Park, Cardiff, United Kingdom
Eleri M. Davies
Affiliation:
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff, United Kingdom
Robin A. Howe
Affiliation:
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff, United Kingdom
*
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff CF14 4XW, UK(mandy.wootton@nphs.wales.nhs.uk)
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Abstract

Background.

The presence of methicillin-resistant Staphylococcus aureus (MRSA) and glycopeptide-intermediate S. aureus (GISA) in hospitals poses a significant challenge to hospital infection control teams. The use of disinfectants for both surface and hand cleaning is an essential part of the infection control measures.

Objective.

To evaluate the effectiveness of common hospital hand disinfectants against MRSA, GISA, and heterogeneous GISA (hGISA).

Methods.

For methicillin-susceptible S. aureus (MSSA), MRSA, GISA, and hGISA, the levels of susceptibility to hand disinfectants and their active ingredients were determined. Suspension tests were performed on commercial handwashing products.

Results.

Minimum inhibitory concentrations (MICs) of 2-propanol, Chlorhexidine, and hexachlorophene were similar for all phenotypes. The MICs of cetrimide and triclosan were higher for the MRSA, GISA, and hGISA strains than for the MSSA strain. The MICs for the chlorhexidine-containing agents Hibisol and Hibiscrub (AstraZeneca) and for the propanol-containing agent Sterillium (Medline) were 1-2-fold lower for the MSSA strains than for the MRSA, GISA, and hGISA strains. Suspension tests showed that the GISA and hGISA strains were less susceptible to the triclosan-containing agent Aquasept (SSL) than were the MRSA and MSSA strains, with resistance increasing with glycopeptide resistance. Products containing Betadine (Purdue) were more effective against the GISA and hGISA strains than against the MRSA and MSSA strains, especially after the strain was exposed to the product for 30 seconds.

Conclusions.

Using the EN 1040 standard criteria for the performance of disinfectants, we determined that all agents, except 50% Aquasept for hGISA and 0.33% hexachlorophene for GISA, performed effectively. However, the GISA and hGISA strains were less susceptible to triclosan-containing products, compared with the MRSA stains, but were more susceptible to products containing Betadine.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 3 , March 2009 , pp. 226 - 232
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Irizarry, L, Merlin, T, Rupp, J, et al.Reduced susceptibility of methicillin-resistant Staphylococcus aureus to cetylpyridinium chloride and Chlorhexidine. Chemotherapy 1996;42:248–252.Google Scholar
2.Kampf, G, Jarosch, R, Rüden, H. Limited effectiveness of Chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect 1998;38:297–303.Google Scholar
3.Al-Masaudi, SB, Day, MJ, Russell, AD. Sensitivity of methicillin-resistant Staphylococcus aureus to some antibiotics, antiseptics and disinfectants. J Appi Bacteriol 1988;65:329–337.Google Scholar
4.Akimitsu, N, Hamamoto, H, Inoue, R, et al.Increase in resistance of methicillin-resistant Staphylococcus aureus to β-lactams caused by mutations conferring resistance to benzalkonium chloride, a disinfectant widely used in hospitals. Antimicrob Agents Chemother 1999;43:3042–3043.Google Scholar
5.Smith, K, Gemmell, CG, Hunter, IS. The association between biocide tolerance and the presence or absence of qac genes among hospital-acquired and community-acquired MRSA isolates. J Antimicrob Chemother 2008;61:78–84.Google Scholar
6.Littlejohn, TG, DiBeradino, D, Messerotti, LJ, Spiers, SJ, Skurray, RA. Structure and evolution of a family of genes encoding antiseptic and disinfectant resistance in Staphylococcus aureus. Gene 1991;101:59–66.Google Scholar
7.Grinius, L, Dreguniene, G, Goldberg, EB, et al.A staphylococcal multidrug resistance gene product is a member of a new protein family. Plasmid 1992;27:119–129.CrossRefGoogle ScholarPubMed
8.Noguchi, N, Hase, M, Kitta, M, Sasatsu, M, Deguchi, K, Kono, M. Antiseptic susceptibility and distribution of antiseptic-resistance genes in methicillin-resistant Staphylococcus aureus. FEMS Microbiol Lett 1999;172:247–253.Google Scholar
9.Sidhu, MS, Heir, E, Leegaard, T, et al.Frequency of disinfectant resistance genes and genetic linkage with β-lactamase transposon Tn552 among clinical staphylococci. Antimicrob Agents Chemother 2002;46:2797–2803.Google Scholar
10.Weigel, LM, Clewell, DB, Gill, SR, et al.Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus. Science 2003;302:1569–1571.Google Scholar
11.Berg, T, Firth, N, Apisiridej, S, Hettiaratchi, A, Leelaporn, A, Skurray, RA. Complete nucleotide sequence of pSK41: evolution of staphylococcal conjugative multiresistant plasmids. J Bacteriol 1998;180:4350–4359.Google Scholar
12.Lyon, BR, Skurray, R. Antimicrobial resistance of Staphylococcus aureus: genetic basis. Microbiol Rev 1987;51:88–134.Google Scholar
13.Paulsen, IT, Gillespie, MT, Littlejohn, TG, et al.Characterisation of sin, a potential recombinase encoding gene of Staphylococcus aureus. Gene 1994;141:109–114.Google Scholar
14.Brown, MR, Gilbert, P. Sensitivity of biofilms to antimicrobial agents. J Appi Bacteriol 1993;74 Suppl:87S–97S.Google Scholar
15.Russell, AD. Mechanisms of bacterial resistance to biocides. Int Biodeterior Biodegrad 1995;36:247–265.Google Scholar
16.Gilbert, P, Brown, MR. Some perspectives on preservation and disinfection in the present day. Int Biodeterior Biodegrad 1995;36:219–226.CrossRefGoogle Scholar
17.Russell, AD, Russell, NJ. Biocides: activity, action and resistance. Symp Soc Gen Microb 1995;53:327–365.Google Scholar
18.CLSI. Performance standards for antimicrobial susceptibility testing. CLSI document. Wayne, PA: CLSI, 2003:M100–S13.Google Scholar
19.Council of Europe. Test methods for the antimicrobial activity of disinfectants in food hygiene. Strasbourg, France: Council of Europe, 1987.Google Scholar
20. British Standard EN 1040:1997. Chemical disinfectants and antiseptics. Basic bactericidal activity—test method and requirements (phase 1). 1997.Google Scholar
21.Suller, MT, Russell, AD. Antibiotic and biocide resistance in methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. J Hosp Infect 1999;43:281–291.Google Scholar
22.Evans, DJ, Allison, DG, Brown, M, et al.Growth rate and the resistance of gram-negative biofilms to cetrimide. J Antimicrob Chemother 1990;26:473–478.CrossRefGoogle ScholarPubMed
23.Pfeltz, RF, Singh, VK, Schmidt, JL, et al.Characterisation of passage-selected vancomycin-resistant Staphylococcus aureus strains of diverse parental backgrounds. Antimicrob Agents Chemother 2000;44:294–303.Google Scholar
24.Sakoulas, G, Eliopoulos, GM, Moellering, RC Jr, et al.Accessory gene regulator (agr) locus in geographically diverse Staphylococcus aureus isolates with reduced susceptibility to vancomycin. Antimicrob Agents Chemother 2002;46:1492–1502.Google Scholar
25.Cookson, BD. Antiseptic resistance in methicillin-resistant Staphylococcus aureus: an emerging problem. In: Proceedings of the Seventh International Symposium. Stokholm, Sweden; 1994:227–234.Google Scholar
26.Bamber, AI, Neal, TJ. An assessment of triclosan susceptibility in methicillin-resistant and methicillin-sensitive Staphylococcus aureus. J Hosp Infect 1999;41:107–109.Google Scholar
27.Al-Doori, Z, Morrison, D, Edwards, G, Gemmell, C. Susceptibility of MRSA to triclosan. J Antimicrob Chemother 2003;51:185–186.Google Scholar
28.Brenwald, NP, Fraise, AP. Triclosan resistance in methicillic-resistant Staphylococcus aureus (MRSA). J Hosp Infect 2003;55:141–144.Google Scholar
29.Cookson, BD, Bolton, MC, Platt, JH. Chlorhexidine resistance in Staphylococcus aureus or just an elevated MIC? An in vitro and in vivo assessment. Antimicrob Agents Chemother 1991;35:1997–2002.Google Scholar
30.Farrelly, HD, Stapleton, P, Garvey, RP, Price, MR, Cookson, BD. Transferable triclosan resistance in methicillin-resistant Staphylococcus aureus. In: “Clinical Microbiology New Perspectives, “ Joint Meeting of the Association of Medical Microbiology, British Society for Antimicrobial Chemotherapy, Hospital Infection Society and Irish Society of Clinical Microbiology. Dublin, Ireland; 1992. Abstract 41.Google Scholar