| Autor: |
Renzoni, A., Von Dach, E., Landelle, C., Diene, S. M., Manzano, C., Gonzales, R., Abdelhady, W., Randall, C. P., Bonetti, E. J., Baud, D., O'Neill, A. J., Bayer, A., Cherkaoui, A., Schrenzel, J., Harbarth, S., François, P. |
| Zdroj: |
Antimicrobial Agents and Chemotherapy; August 2017, Vol. 61 Issue: 10 |
| Abstrakt: |
ABSTRACTMethicillin-resistant Staphylococcus aureus(MRSA) resistant to decolonization agents such as mupirocin and chlorhexidine increases the need for development of alternative decolonization molecules. The absence of reported severe adverse reactions and bacterial resistance to polyhexanide makes it an excellent choice as a topical antiseptic. In the present study, we evaluated the in vitroand in vivocapacity to generate strains with reduced polyhexanide susceptibility and cross-resistance with chlorhexidine and/or antibiotics currently used in clinic. Here we report the in vitroemergence of reduced susceptibility to polyhexanide by prolonged stepwise exposure to low concentrations in broth culture. Reduced susceptibility to polyhexanide was associated with genomic changes in the mprFand purRgenes and with concomitant decreased susceptibility to daptomycin and other cell wall-active antibiotics. However, the in vitroemergence of reduced susceptibility to polyhexanide did not result in cross-resistance to chlorhexidine. During in vivopolyhexanide clinical decolonization treatment, neither reduced polyhexanide susceptibility nor chlorhexidine cross-resistance was observed. Together, these observations suggest that polyhexanide could be used safely for decolonization of carriers of chlorhexidine-resistant S. aureusstrains; they also highlight the need for careful use of polyhexanide at low antiseptic concentrations. |
| Databáze: |
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