Effects of a sub-minimum inhibitory concentration of chlorhexidine gluconate on the development of <i>in vitro</i> multi-species biofilms

Suzuki, Yuki; Ohsumi, Tatsuya; Isono, Toshihito; Nagata, Ryoko; Hasegawa, Taisuke; Takenaka, Shoji; Terao, Yutaka; Noiri, Yuichiro

doi:10.1080/08927014.2020.1739271

Cited by 10 publications

(14 citation statements)

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“…The antiseptics used included ve different CHX salts (digluconate 33,35,37,40,47,50,[55][56][57][58]61,63,67,69,74,75,81,83,88,90,94,97,99,101,106,107,111,113 , gluconate 34,36,42,42,53,91,102,103,108,108,109,112 , dichlorohydrate 85-87 , diacetate 71,99 and dihydrochloride 96 ) and povidone-iodine 37,46,49,70,76,91 . In total, MBC data from 6218 microbes were extracted.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…When controlling for resistance to methicillin (MRSA vs MSSA), there was still no evidence of a change in the MBC over time (β 0.26 [-0.87, 1.34]; I 2 99%). Study level estimates for MSSA, MRSA and coagulasenegative Staphylococci are shown in S1 Fig.Overall, 25 studies reported the MBC of CHX for Streptococci species; observations of viridans Streptococci were most common44,45,47,48,[52][53][54]58,66,69,75,[77][78][79]81,82,[84][85][86]89,99,100,103,105,106 and 1 study 106 provided an estimate for Streptococcus pyogenes (Lance eld group A). The pooled mean MBC of CHX for Streptococci was 8.54 mg/L (95% CI 4.75, 12.3; I 2 99%).…”

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confidence: 99%

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Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

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Dodhia

Jeanes

et al. 2022

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Background Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is increasing concern of developing resistance to topical biocides, though clinical implications remain unclear. Outcomes: Determining whether the Minimum Bactericidal Concentration (MBC) for topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. Methods We included studies reporting the mean bactericidal concentration (MBC) of laboratory and clinical isolates of common microbes to CHX and PVI. Excluding non-human samples and studies using antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses. Change in MBC over time was explored using meta-regression. Results 79 studies were including, analysing 6218 microbes over 45 years. Most used CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in MBC of CHX to Staphylococci (β 0.12 [-1.13, 1.37]; I2 99%) or Streptococci (β 0.13 [-0.35, 0.62]; I2 97%). Conclusions There is no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. Providing reassurance that the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.

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Section: Study Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Aftab

Dodhia

Jeanes

et al. 2022

Preprint

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“…Articles were published between 1976 and 2021, although the majority (95%) were published this century. The antiseptics used included five different CHX salts (digluconate (33,35,37,40,47,50,(55)(56)(57)(58)61,63,67,69,74,75,81,83,88,90,94,97,99,101,106,107,111,113), gluconate (34,36,42,42,53,91,102,103,108,108,109,112), dichlorohydrate (85)(86)(87), diacetate (71,99) and dihydrochloride( 96)) and povidone-iodine (37,46,49,…”

Section: Study Characteristicsmentioning

confidence: 99%

Bacterial Sensitivity to Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Aftab

Dodhia

Jeanes

et al. 2021

Preprint

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BackgroundSurgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Topical biocides such as chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis to minimise SSIs. There is an increasing concern of developing resistance to topical biocides, however the clinical implications of this remains unclear.OutcomesThe objective of this review was to determine whether the Minimum Bactericidal Concentration (MBC) for topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI.MethodsWe searched for studies which reported the mean bactericidal concentration (MBC) of laboratory and clinical isolates of common SSI causing microbes to CHX and PVI. We excluded samples derived from non-humans and studies using antimicrobial solvents or mixtures of biocides with other active substances. MBC was pooled in random effects meta-analyses and change in MBC over time was explored using meta-regression.Results79 studies were including, analysing 6218 microbes between 1976 and 2021. Most studies used CHX (93%) and there was insufficient data for meta-analysis of PVI. Enterobacteriales had the highest MBC for CHX (20 mg/L [95% CI 14, 25]; I2 95%) whilst MRSA had the lowest (3 mg/L [95% CI 1, 2]; I2 93%). There was no change in MBC of CHX to Staphylococci (β 0.12 [-1.13, 1.37]; I2 99%) or Streptococci (β 0.13 [-0.35, 0.62]; I2 97%).ConclusionsThere is no evidence of change in susceptibility of common SSI-causing microbes to CHX over time. This study provides reassurance that the worldwide guidance that CHX should remain the first-choice agent for skin asepsis prior to surgery.

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“…In other words, the biofilm cannot be removed only by immersion in the mouthwash. In one study, there was a report that the effect of chlorhexidine digluconate on biofilms caused a concentration gradient in the antimicrobial component, which was below the minimum inhibitory concentration and enhanced biofilm formation [20].…”

Section: Introductionmentioning

confidence: 99%

Adjunct use of mouth rinses with a sonic toothbrush accelerates the detachment of a Streptococcus mutans biofilm: an in vitro study

et al. 2020

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Background: The aim of this in vitro study was to examine the possible enhancement of the biofilm peeling effect of a sonic toothbrush following the use of an antimicrobial mouth rinse. Methods: The biofilm at a noncontact site in the interdental area was treated by sound wave convection with the test solution or by immersion in the solution. The biofilm peeling effect was evaluated by determining the bacterial counts and performing morphological observations. A Streptococcus mutans biofilm was allowed to develop on composite resin discs by cultivation with stirring at 50 rpm for 72 h. The specimens were then placed in recesses located between plastic teeth and divided into an immersion group and a combination group. The immersion group was treated with phosphate buffer, chlorhexidine digluconate Peridex™ (CHX) mouth rinse or Listerine® Fresh Mint (EO) mouth rinse. The combination group was treated with CHX or EO and a sonic toothbrush. Results: The biofilm thickness was reduced by approximately one-half compared with the control group. The combination treatment produced a 1 log reduction in the number of bacteria compared to the EO immersion treatment. No significant difference was observed in the biofilm peeling effect of the immersion group compared to the control group. Conclusions: The combined use of a sonic toothbrush and a mouth rinse enhanced the peeling of the biofilm that proliferates in places that are difficult to reach using mechanical stress.

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Effects of a sub-minimum inhibitory concentration of chlorhexidine gluconate on the development of in vitro multi-species biofilms

Cited by 10 publications

References 48 publications

Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Bacterial Sensitivity to Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Adjunct use of mouth rinses with a sonic toothbrush accelerates the detachment of a Streptococcus mutans biofilm: an in vitro study

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