Volume 35, Issue 5 (August 2024)                   Studies in Medical Sciences 2024, 35(5): 425-433 | Back to browse issues page

Ethics code: IR.QUMS.REC.1403.073


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Safavi S, Peyman gohar M, Khakpour M, Fardsanei F, Nikkhahi F. EVALUATION OF THE EFFECT OF CHLORHEXIDINE AND EDTA ON MULTI-DRUG RESISTANT STRAINS OF KLEBSIELLA PNEUMONIAE AND BIOFILM-PRODUCING AND NON-PRODUCING ESCHERICHIA COLI. Studies in Medical Sciences 2024; 35 (5) :425-433
URL: http://umj.umsu.ac.ir/article-1-6272-en.html
Assistant Professor of Medical Bacteriology, Medical Microbiology Research Center, Qazvin, Iran (Corresponding Author) , farhadnikkhahi@gmail.com
Abstract:   (287 Views)
Background & Aims: Escherichia coli and Klebsiella pneumoniae are important bacteria that cause hospital-acquired infections and have become resistant to beta-lactam antibiotics through the acquisition of beta-lactamase-encoding plasmids. Resistance to disinfectants has also been observed in these strains. Therefore, the aim of this study was to investigate the antimicrobial effect of the disinfectant chlorhexidine on multidrug-resistant strains of Escherichia coli and Klebsiella pneumoniae.
Materials & Methods: Clinical samples were collected from the intensive care unit of Qazvin hospital. All isolates were analysed by phenotypic method. Finally, the combined effect of chlorhexidine and EDTA on the collected strains was performed.
Results: 45% of the 70 Escherichia coli isolates were MDR and 83.3% of the 74 Klebsiella pneumoniae isolates. All samples were equally sensitive to chlorhexidine. EDTA showed no synergistic effect with this substance.
Conclusion: The results of our study show that chlorhexidine can effectively destroy Escherichia coli and Klebsiella pneumoniae producing and non-producing biofilm strains. Therefore, this disinfectant can be used at low concentrations to control antibiotic resistance in multidrug-resistant Escherichia coli and Klebsiella pneumoniae bacteria in hospital-acquired infections.
Full-Text [PDF 473 kb]   (151 Downloads)    
Type of Study: Research | Subject: میکروبیولوژی

References
1. Isvand A, Yahyavi M, Asadi-Samani M, Kooti W, Davoodi-Jouneghani Z. The study of bacteriological factors and antibiotic resistance in women with UTI referred to the Razi laboratory in Dezful. J Ilam Univ Med Sci 2014;22(4):199-205. [URL:]
2. De Francesco MA, Ravizzola G, Peroni L, Negrini R, Manca N. Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Med Sci Monit 2007 Jun;13(6):BR136-44. [PMID: 17534228]
3. Alves MS. Alves MS, Dias RC, de Castro AC, Riley LW, Moreira BM. Identification of clinical isolates of indole-positive and indole-negative Klebsiella spp. J Clin Microbiol 2006 Oct;44(10):3640-6. [PMID: 16928968] [DOI:10.1128/JCM.00940-06] [PMCID: PMC1594763]
4. Walker MM, Roberts JA, Rogers BA, Harris PNA, Sime FB. Current and Emerging Treatment Options for Multidrug Resistant Escherichia coli Urosepsis: A Review. Antibiotics [Internet]. 2022 Dec 15 [cited 2024 Oct 11];11(12):1821. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774639/ [URL:] [DOI:10.3390/antibiotics11121821]
5. Ibrahim ME, Bilal NE, Hamid ME. Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan. Afr Health Sci 2012;12(3):368-75. [PMID: 23382754] [DOI:10.4314/ahs.v12i3.19] [PMCID: PMC3557680]
6. Al-Sheboul. Al-Sheboul SA, Al-Madi GS, Brown B, Hayajneh WA. Prevalence of Extended-Spectrum β-Lactamases in Multidrug-Resistant Klebsiella pneumoniae Isolates in Jordanian Hospitals. J Epidemiol Glob Health 2023 Jun;13(2):180-90. [PMID: 37095370] [DOI:10.1007/s44197-023-00096-2] [PMCID: PMC10272028]
7. Gholipour A. Gholipour A, Soleimani N, Shokri D, Mobasherizadeh S, Kardi M, Baradaran A. Phenotypic and Molecular Characterization of Extended-Spectrum β-Lactamase Produced by Escherichia coli, and Klebsiella pneumoniae Isolates in an Educational Hospital. Jundishapur J Microbiol 2014 Oct;7(10):e11758. [PMID: 25632322] [DOI:10.5812/jjm.11758] [PMCID: PMC4295312]
8. Kuloglu TO, Unuvar GK, Cevahir F, Kilic AU, Alp E. Risk factors and mortality rates of carbapenem-resistant Gram-negative bacterial infections in intensive care units. J Intensive Med 2024;4(3):347-54. [PMID: 39035617] [DOI:10.1016/j.jointm.2023.11.007] [PMCID: PMC11258511]
9. Yin W. Yin W, Wang Y, Liu L, He J. Biofilms: The Microbial "Protective Clothing" in Extreme Environments. Int J Mol Sci 2019 Jul 12;20(14):3423. [PMID: 31336824] [DOI:10.3390/ijms20143423] [PMCID: PMC6679078]
10. Koerdt A. Koerdt A, Gödeke J, Berger J, Thormann KM, Albers SV. Crenarchaeal biofilm formation under extreme conditions. PLoS One 2010 Nov 24;5(11):e14104. [PMID: 21124788] [DOI:10.1371/journal.pone.0014104] [PMCID: PMC2991349]
11. Olson ME. Olson ME, Ceri H, Morck DW, Buret AG, Read RR. Biofilm bacteria: formation and comparative susceptibility to antibiotics. Can J Vet Res 2002 Apr;66(2):86-92. [PMID: 11989739] [PMCID: PMC226988]
12. Li J, Liu D, Tian X, Koseki S, Chen S, Ye X, Ding T. Novel antibacterial modalities against methicillin resistant Staphylococcus aureus derived from plants. Crit Rev Food Sci Nutr 2019;59(sup1):S153-S161. [PMID: 30501508] [DOI:10.1080/10408398.2018.1541865]
13. Silva VO, Soares LO, Silva Júnior A, Mantovani HC, Chang YF, Moreira MA. Biofilm formation on biotic and abiotic surfaces in the presence of antimicrobials by Escherichia coli Isolates from cases of bovine mastitis. Appl Environ Microbiol 2014 Oct;80(19):6136-45. [PMID: 25063668] [DOI:10.1128/AEM.01953-14] [PMCID: PMC4178704]
14. Casalini J. Biofilmes microbianos na indústria de alimentos. Universidade Federal de Pelotas. 2008. [URL:]
15. Dahiya S, Singla P, Chaudhary U, Singh B. Carbapenemases: A Review. Int J Adv Health Sci 2015;2(4):11-17. [URL:]
16. Raveh D, Yinnon AM, Broide E, Rudensky B. Susceptibilities of ESBL-Producing Enterobacteriaceae to Ertapenem, Meropenem and Piperacillin-Tazobactam with and without Clavulanic Acid. Chemotherapy 2007;53(3):185-9. [PMID: 17347564] [DOI:10.1159/000100516]
17. Yazdi M, Nazemi A, Mir Inargasi M, Khataminejad MR, Sharifi S, Babai Kochkaksaraei M. Prevalence of SHV/CTX-M/TEM (ESBL) beta-lactamase resistance genes in Escherichia coli isolated from urinary tract infections in Tehran, Iran. [URL:]
18. Kirby-Bauer-Disk-Diffusion-Susceptibility-Test-Protocol-pdf.pdf [Internet]. [cited 2024 Oct 11]. Available from: https://asm.org/getattachment/2594ce26-bd44-47f6-8287-0657aa9185ad/Kirby-Bauer-Disk-Diffusion-Susceptibility-Test-Protocol-pdf.pdf [URL:]
19. White RL, Burgess DS, Manduru M, Bosso JA. Comparison of three different in vitro methods of detecting synergy: time-kill, checkerboard, and E test. Antimicrob Agents Chemother [Internet]. 1996 Aug [cited 2024 Sep 21]; Available from: https://journals.asm.org/doi/10.1128/aac.40.8.1914 [URL:] [DOI:10.1128/AAC.40.8.1914]
20. Kahan JS, Kahan FM, Goegelman R, Currie SA, Jackson M, Stapley EO, et al. Thienamycin, a new .BETA.-lactam antibiotic. I. Discovery, taxonomy, isolation and physical properties. J Antibiot (Tokyo) 1979;32(1):1-12. [PMID: 761989] [DOI:10.7164/antibiotics.32.1]
21. Murphy CN, Clegg S. Klebsiella pneumoniae and type 3 fimbriae: nosocomial infection, regulation and biofilm formation. Future Microbiol. 2012 Aug;7(8):991-1002. [PMID: 22913357] [DOI:10.2217/fmb.12.74]
22. Abbasi E, Mondanizadeh M, van Belkum A, Ghaznavi-Rad E. Multi-Drug-Resistant Diarrheagenic Escherichia coli Pathotypes in Pediatric Patients with Gastroenteritis from Central Iran. Infect Drug Resist 2020:1387-96. [PMID: 32523359] [DOI:10.2147/IDR.S247732] [PMCID: PMC7234969]
23. Ibrahim ME. Risk factors in acquiring multidrug-resistant Klebsiella pneumoniae infections in a hospital setting in Saudi Arabia. Sci Rep 2023;13(1):11626. [PMID: 37468757] [DOI:10.1038/s41598-023-38871-7] [PMCID: PMC10356761]
24. Shadkam S, Goli HR, Mirzaei B, Gholami M, Ahanjan M. Correlation between antimicrobial resistance and biofilm formation capability among Klebsiella pneumoniae strains isolated from hospitalized patients in Iran. Ann Clin Microbiol Antimicrob 2021;20(1):13. [PMID: 33588850] [DOI:10.1186/s12941-021-00418-x] [PMCID: PMC7885248]
25. Maillard JY. Bacterial resistance to biocides in the healthcare environment: should it be of genuine concern? J Hosp Infect. 2007 Jun;65 Suppl 2:60-72. [PMID: 17540245] [DOI:10.1016/S0195-6701(07)60018-8]
26. Maillard JY. Bacterial target sites for biocide action. J Appl Microbiol. 2002;92 Suppl:16S-27S. [PMID: 12000609] [DOI:10.1046/j.1365-2672.92.5s1.3.x]
27. Forbes S, Latimer J, Bazaid A, McBain AJ. Altered Competitive Fitness, Antimicrobial Susceptibility, and Cellular Morphology in a Triclosan-Induced Small-Colony Variant of Staphylococcus aureus. Antimicrob Agents Chemother 2015 Aug;59(8):4809-16. [PMID: 26033734] [DOI:10.1128/AAC.00352-15] [PMCID: PMC4505237]
28. Wieland N, Boss J, Lettmann S, Fritz B, Schwaiger K, Bauer J, Hölzel CS. Susceptibility to disinfectants in antimicrobial-resistant and -susceptible isolates of Escherichia coli, Enterococcus faecalis and Enterococcus faecium from poultry-ESBL/AmpC-phenotype of E. coli is not associated with resistance to a quaternary ammonium compound, DDAC. J Appl Microbiol 2017 Jun;122(6):1508-1517. [PMID: 28261951] [DOI:10.1111/jam.13440]
29. Nikaido H, Rosenberg EY, Foulds J. Porin channels in Escherichia coli: studies with beta-lactams in intact cells. J Bacteriol. 1983 Jan;153(1):232-40. [PMID: 6294048] [DOI:10.1128/jb.153.1.232-240.1983] [PMCID: PMC217361]
30. Hawkey PM, Livermore DM. Carbapenem antibiotics for serious infections. BMJ 2012 May 31;344:e3236. [PMID: 22654063] [DOI:10.1136/bmj.e3236]
31. Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA. Carbapenems: Past, Present, and Future. Antimicrob Agents Chemother 2011 Nov;55(11):4943-60. [PMID: 21859938] [DOI:10.1128/AAC.00296-11] [PMCID: PMC3195018]
32. Von Döhren H. Antibiotics: Actions, origins, resistance, by C. Walsh. 2003. Washington, DC: ASM Press. 345 pp. $99.95 (hardcover). Protein Sci 2009 Jan 1;13(11):3059-60. [URL:] [DOI:10.1110/ps.041032204]
33. KRAUß J, van der LINDEN M, Grebe T, Hakenbeck R. Penicillin-Binding Proteins 2x and 2b as Primary PBP Targets in Streptococcus pneumoniae. Microb Drug Resist 1996 Jan;2(2):183-6. [PMID: 9158757] [DOI:10.1089/mdr.1996.2.183]
34. Tenover FC, Raney PM, Williams PP, Rasheed JK, Biddle JW, Oliver A, et al. Evaluation of the NCCLS Extended-Spectrum β-Lactamase Confirmation Methods for Escherichia coli with Isolates Collected during Project ICARE. J Clin Microbiol 2003 Jul;41(7):3142-6. [PMID: 12843054] [DOI:10.1128/JCM.41.7.3142-3146.2003] [PMCID: PMC165309]
35. Cieplik F, Jakubovics NS, Buchalla W, Maisch T, Hellwig E, Al-Ahmad A. Resistance Toward Chlorhexidine in Oral Bacteria - Is There Cause for Concern? Front Microbiol 2019 Mar 22;10:587. [PMID: 30967854] [DOI:10.3389/fmicb.2019.00587] [PMCID: PMC6439480]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Studies in Medical Sciences

Designed & Developed by : Yektaweb