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Antiseptic and antibiotic resistance in gram-negative bacteria causing urinary tract infection in spinal cord injured

D J Stickler, B Thomas, J C Chawla

    Paraplegia
    |January 1, 1981
    PubMed

    Insights

    Urinary tract infections in spinal cord injured patients show resistance to common antiseptics like chlorhexidine. Extensive use of cationic antiseptics may select for drug-resistant bacterial species, impacting patient care.

    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Antimicrobial Resistance

    Background:

    • Urinary tract infections (UTIs) are common in spinal cord injured (SCI) patients.
    • Antiseptic use in bladder management is a critical concern for preventing and treating UTIs in this population.

    Purpose of the Study:

    • To evaluate the in vitro sensitivity of Gram-negative bacterial isolates from SCI patients to various antiseptics.
    • To investigate the relationship between antiseptic resistance and antibiotic resistance in these isolates.

    Main Methods:

    • Testing sensitivity of 57 Gram-negative bacterial isolates from SCI patients' UTIs against chlorhexidine, cetrimide, glutaraldehyde, phenyl mercuric nitrate (PMN), Hycolin, and Resiguard.
    • Assessing antibiotic resistance patterns and minimum inhibitory concentrations (MICs) for cationic antiseptics.

    Main Results:

    • No resistance observed to glutaraldehyde, Hycolin, or PMN.
    • Substantial resistance detected for chlorhexidine (44%), cetrimide (26%), and Resiguard (42%).
    • Resistant strains (Proteus, Providencia, Pseudomonas) showed multi-drug resistance and correlations between antibiotic resistance and cationic antiseptic MICs.

    Conclusions:

    • Extensive use of cationic antiseptics in SCI patient bladder management may inadvertently select for multi-drug resistant bacterial species.
    • Antiseptic stewardship is crucial to prevent the emergence of resistant uropathogens in SCI populations.

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