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Octenidine exposure was not associated with reduced Octenidine susceptibility of meticillin-resistant Staphylococcus aureus (MRSA) in an extended-care facility in Singapore.
Journal of Hospital Infection 2024 April 25
OBJECTIVES: Antiseptics such as chlorhexidine gluconate (CHG) and octenidine dihydrochloride (OCT) are frequently used in hospitals to prevent and control meticillin-resistant Staphylococcus aureus (MRSA) transmission. With increasing prevalence of reduced CHG susceptibility of MRSA, concerns are raised about the possibility of reduced OCT susceptibility. Hence, we evaluated the prevalence of reduced CHG and OCT susceptibility over 3 years and assessed the association between exposure to OCT and MRSA reduced susceptibility to OCT.
METHODS: MRSA isolates from inpatients who acquired MRSA in an extended-care facility from 2019 to 2021, were included for antiseptic susceptibility testing. Inpatients were exposed to universal daily CHG bathing from January to September 2019, and universal daily OCT bathing after October 2019. The minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Multivariable logistic regression was used to assess if exposure to OCT bathing was independently associated with reduced OCT susceptibility.
RESULTS: Of 186 isolates, 179 (96%) had reduced CHG susceptibility (MIC ≥4 mg/L) whilst 46 (25%) had reduced OCT susceptibility (MIC ≥2 mg/L). OCT reduced susceptibility rates were 26.9%, 13.8% and 14.3% in 2019, 2020 and 2021, respectively. CHG reduced susceptibility rates were 95.4%, 100% and 95.9% in 2019, 2020 and 2021, respectively. OCT exposure was not associated with reduced OCT susceptibility (adjusted odds ratio [aOR] 0.23, 95% confidence interval [CI] 0.08 - 0.75, p 0.014), after adjusting for age, gender, race, sample collection year, days-at-risk in facility, past hospitalisation and previous MRSA in the preceding year.
CONCLUSION: The prevalence of reduced OCT susceptibility has remained low, despite universal OCT bathing for extended inpatient care. However, CHG reduced susceptibility rates were high. OCT exposure was not associated with reduced OCT susceptibility in MRSA.
METHODS: MRSA isolates from inpatients who acquired MRSA in an extended-care facility from 2019 to 2021, were included for antiseptic susceptibility testing. Inpatients were exposed to universal daily CHG bathing from January to September 2019, and universal daily OCT bathing after October 2019. The minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Multivariable logistic regression was used to assess if exposure to OCT bathing was independently associated with reduced OCT susceptibility.
RESULTS: Of 186 isolates, 179 (96%) had reduced CHG susceptibility (MIC ≥4 mg/L) whilst 46 (25%) had reduced OCT susceptibility (MIC ≥2 mg/L). OCT reduced susceptibility rates were 26.9%, 13.8% and 14.3% in 2019, 2020 and 2021, respectively. CHG reduced susceptibility rates were 95.4%, 100% and 95.9% in 2019, 2020 and 2021, respectively. OCT exposure was not associated with reduced OCT susceptibility (adjusted odds ratio [aOR] 0.23, 95% confidence interval [CI] 0.08 - 0.75, p 0.014), after adjusting for age, gender, race, sample collection year, days-at-risk in facility, past hospitalisation and previous MRSA in the preceding year.
CONCLUSION: The prevalence of reduced OCT susceptibility has remained low, despite universal OCT bathing for extended inpatient care. However, CHG reduced susceptibility rates were high. OCT exposure was not associated with reduced OCT susceptibility in MRSA.
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