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Limited effectiveness of chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus
Abstract:
Hand disinfectants containing chlorhexidine are thought to be less bactericidal against methicillin-resistant Staphylococcus aureus (MRSA) than methicillin-susceptible Staphylococcus aureus (MSSA). We report an in vitro comparison between three distinct MRSA strains and three MSSA strains. The bactericidal efficacy of chlorhexidine digluconate, 'Hibiscrub' and 'Hibisol' against Staphylococcus aureus was determined in a quantitative suspension test. Logarithmic reduction factors (RF) were calculated for each of six parallel experiments. Chlorhexidine digluconate and 'Hibisol' showed RF > 5 at most concentrations and reaction times but 'Hibiscrub' did not. MRSA was found to be significantly less susceptible than MSSA to chlorhexidine digluconate, 'Hibiscrub' and 'Hibisol' (P < 0.05; two-tailed t-test for independent samples). 'Hibisol' was significantly more effective against MRSA than 'Hibiscrub' (P < 0.05). Hand disinfectants containing both alcohol and chlorhexidine (e.g., 'Hibisol') are more effective against MRSA than scrubs based only on chlorhexidine ('Hibiscrub') and should be used in clinical practice.
Insights
Hand disinfectants with chlorhexidine show reduced efficacy against methicillin-resistant Staphylococcus aureus (MRSA). Alcohol-based formulations like Hibisol are more effective against MRSA than chlorhexidine-only products like Hibiscrub.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Chlorhexidine-based hand disinfectants are widely used.
- Concerns exist regarding their effectiveness against methicillin-resistant Staphylococcus aureus (MRSA).
- MRSA poses a significant healthcare-associated infection challenge.
Purpose of the Study:
- To compare the in vitro bactericidal efficacy of chlorhexidine formulations against MRSA and methicillin-susceptible Staphylococcus aureus (MSSA).
- To evaluate specific hand disinfectant products: chlorhexidine digluconate, Hibiscrub, and Hibisol.
Main Methods:
- Quantitative suspension tests were performed.
- Bactericidal efficacy was assessed using logarithmic reduction factors (RF).
- Six strains (3 MRSA, 3 MSSA) were tested against different chlorhexidine concentrations and contact times.
Main Results:
- Chlorhexidine digluconate and Hibisol demonstrated significant bactericidal activity (RF > 5) against Staphylococcus aureus.
- MRSA strains were significantly less susceptible to chlorhexidine digluconate, Hibiscrub, and Hibisol compared to MSSA strains (P < 0.05).
- Hibisol showed significantly greater efficacy against MRSA than Hibiscrub (P < 0.05).
Conclusions:
- Hand disinfectants containing both alcohol and chlorhexidine (Hibisol) are more effective against MRSA than chlorhexidine-only formulations (Hibiscrub).
- Alcohol-containing chlorhexidine disinfectants are recommended for clinical practice to combat MRSA.
- Further research into optimizing disinfectants against resistant bacteria is warranted.