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Antiseptic and antibiotic resistance in Gram-negative bacteria causing urinary tract infection
Abstract:
A collection of 802 isolates of Gram-negative bacteria causing urinary tract infections was made from general practice, antenatal clinics, and local hospitals. The organisms were tested for their sensitivity to chlorhexidine, cetrimide, glutaraldehyde, phenyl mercuric nitrate, a phenolic formulation, and a proprietary antiseptic containing a mixture of picloxydine, octyl phenoxy polyethoxyethanol, and benzalkonium chloride. Escherichia coli, the major species isolated, proved to be uniformly sensitive to these agents. Approximately 10% of the total number of isolates, however, exhibited a degree of resistance to the cationic agents. These resistant organisms were members of the genera Proteus, Providencia, and Pseudomonas; they were also generally resistant to five, six, or seven antibiotics. It is proposed therefore that an antiseptic policy which involves the intensive use of cationic antiseptics might lead to the selection of a flora of notoriously drug-resistant species.
Insights
Intensive use of cationic antiseptics may select for drug-resistant bacteria. Some Gram-negative urinary tract infection isolates showed resistance to cationic agents and multiple antibiotics.
Area of Science:
- Microbiology
- Antimicrobial Resistance
- Public Health
Background:
- Urinary tract infections (UTIs) are common, often caused by Gram-negative bacteria.
- Antiseptic use is widespread in healthcare settings.
- Understanding antiseptic efficacy and potential resistance is crucial.
Purpose of the Study:
- To assess the sensitivity of Gram-negative UTI pathogens to various antiseptics.
- To investigate potential links between antiseptic resistance and antibiotic resistance.
Main Methods:
- Collected 802 Gram-negative bacterial isolates from UTIs.
- Tested isolates for sensitivity to six different antiseptics.
- Assessed antibiotic resistance profiles of selected isolates.
Main Results:
- Escherichia coli showed uniform sensitivity to all tested antiseptics.
- 10% of isolates, primarily Proteus, Providencia, and Pseudomonas, exhibited resistance to cationic agents.
- Resistant strains were often multidrug-resistant to antibiotics.
Conclusions:
- Intensive use of cationic antiseptics may inadvertently select for drug-resistant bacterial strains.
- This could lead to an increase in difficult-to-treat infections.
- Antiseptic stewardship is important to mitigate antimicrobial resistance.