The antimicrobial effectiveness of chlorhexidine and chlorhexidine-silver sulfadiazine-impregnated central venous catheters against the emerging fungal pathogen Candida auris.

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES American journal of infection control Pub Date : 2024-06-27 DOI:10.1016/j.ajic.2024.06.015

Nisha Gupta, Shanna Haughton, Sydney Kemper, Monica Koehler, Roula Antoon, Colin G Edwards, Amy Bardin

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Abstract

Background: Candida auris is an emerging multidrug-resistant fungus associated with catheter-related bloodstream infections. In vitro efficacy of chlorhexidine (CHX) and CHX-silver sulfadiazine-impregnated (CHX-S) antimicrobial central venous catheters (CVCs) against C auris was investigated.

Methods: Minimum inhibitory and bactericidal CHX concentrations were determined against 19 C auris isolates. To assess extraluminal efficacy, segments from CVCs impregnated externally (CHX-S1) and both externally and internally (CHX-S2) were plasma-conditioned for 1- and 6-day, and to assess intraluminal efficacy, CHX-S2 CVCs were preconditioned with saline-lock for 6days, followed by 24-hour C auris inoculation and microbial adherence determination on impregnated and nonimpregnated CVCs.

Results: CHX inhibited all C auris isolates with minimum inhibitory and bactericidal concentrations range of 8 to 128 μg/mL. C auris adherence was reduced on CHX-S1 and CHX-S2 extraluminally by 100% on day 1, 86.96% to 100% on day 7, and intraluminally on CHX-S2 by 56.86% to 90.52% on day 7.

Discussion: CHX and CHX-S CVC performance against C auris observed in this study is consistent with antimicrobial benefits observed in prior preclinical and randomized controlled clinical studies.

Conclusions: CHX showed strong inhibitory and cidal effects on C auris. CHX-S CVCs proved highly efficacious against this pathogen under in vitro conditions. Additional studies, however, are required to confirm clinical benefit.

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洗必泰和洗必泰-磺胺嘧啶银浸渍中心静脉导管对新出现的真菌病原体白色念珠菌的抗菌效果。

背景：念珠菌是一种新出现的耐多药真菌，与导管相关血流感染（CRBSI）有关。研究了洗必泰（CHX）和CHX/磺胺嘧啶银浸渍（CHX-S）抗菌中心静脉导管（CVC）对念珠菌的体外疗效：测定了 CHX 对 19 种弧菌分离物的最低抑菌浓度（MIC）和杀菌浓度（MBC）。为了评估腔外疗效，将外部浸渍（CHX-S1）和外部及内部浸渍（CHX-S2）的 CVC 管段分别进行血浆预处理 1 天和 6 天；为了评估腔内疗效，将 CHX-S2 CVC 用生理盐水预处理 6 天，然后在浸渍和未浸渍的 CVC 上接种 24 小时的弧菌，并测定微生物的附着力：结果：CHX 可抑制所有弧菌分离株，其 MIC 和 MBC 范围为 8-128 μg/mL。第 1 天，CHX-S1 和 CHX-S2 的腔外粘附率降低了 100%，第 7 天降低了 86.96%-100%；第 7 天，CHX-S2 的腔内粘附率降低了 56.86%-90.52%：讨论：本研究中观察到的 CHX 和 CHX-S CVC 对弧菌的作用与之前临床前研究和随机对照临床研究中观察到的抗菌效果一致：结论：CHX 对蛔虫有很强的抑制和杀灭作用。在体外条件下，CHX-S CVC 对这种病原体具有很高的疗效。然而，还需要更多的研究来证实临床疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)