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Variable chlorhexidine MICs across Klebsiella species from a single facility

David Lehman1, Aubrey E Hetzler1, Tayloe Friedrich1

  • 1Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA.

Antimicrobial Agents and Chemotherapy
|February 9, 2026
PubMed

Insights

This study found varying chlorhexidine resistance in hospital Klebsiella species. Klebsiella quasipneumoniae showed the highest minimal inhibitory concentrations (MICs), suggesting biocides shape microbial resistance.

Area of Science:

  • Microbiology
  • Antimicrobial Resistance
  • Hospital Epidemiology

Background:

  • Chlorhexidine is a widely used hospital antiseptic.
  • Increasing biocide use may drive antimicrobial resistance in bacteria.
  • Klebsiella species are common hospital-acquired pathogens.

Purpose of the Study:

  • To evaluate in vitro chlorhexidine minimal inhibitory concentrations (MICs) across different Klebsiella species.
  • To investigate potential genetic factors associated with chlorhexidine resistance in Klebsiella.
  • To understand the impact of chlorhexidine use on Klebsiella populations in a hospital setting.

Main Methods:

  • Collected Klebsiella isolates from a hospital environment with extensive chlorhexidine usage.
  • Performed in vitro minimal inhibitory concentration (MIC) testing for chlorhexidine.
  • Conducted whole genome sequencing on the isolates.

Main Results:

  • Significant variation in chlorhexidine MICs was observed among Klebsiella species.
  • Klebsiella quasipneumoniae exhibited the highest MICs compared to other species.
  • No direct correlation found with acquired resistance genes; however, chromosomal efflux pumps varied by species.

Conclusions:

  • Species-specific differences in chlorhexidine susceptibility exist within the Klebsiella genus.
  • Chromosomal factors, like efflux pumps, may play a role in intrinsic resistance.
  • Hospital biocides like chlorhexidine can potentially influence the composition and resistance profiles of microbial communities.
Keywords:
Carbapenemase producing EnterobacteralesChlorhexidine toleranceHospital environmentKlebsiella quasipneumoniae

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