In Vitro Evaluation of Povidone-Iodine and Chlorhexidine against Outbreak and Nonoutbreak Strains of Mycobacterium abscessus Using Standard Quantitative Suspension and Carrier Testing

Abstract

Povidone-iodine (PI) and chlorhexidine (CHX) are widely used antiseptics active against conventional ,, species, and viruses, but their efficacy against remains unproven. We determined the potency of alcoholic PI and CHX against subsp. (ATCC 19977), subsp. (BCRC 16915), and our outbreak strain of subsp. (TPE 101) in reference to (ATCC 29213) by standard quantitative suspension and carrier methods (EN 14563). By suspension, all mycobacterial strains compared to were significantly more resistant to CHX, but not PI. By carrier, the mean logarithmic reductions (LR) achieved by PI under clean (dirty) conditions were 6.575 (2.482), 5.540 (2.298), 4.595 (1.967), and 1.173 (0.889), while those achieved by CHX under clean (dirty) conditions were 3.164 (5.445), 5.307 (2.564), 3.844 (2.232), and 0.863 (0.389) for, subsp., subsp., and subsp., respectively. subsp. (outbreak strain) was significantly more resistant than the other tested strains to PI and CHX. By both methods, the mean LR achieved by PI was higher than for CHX for all mycobacterial strains, but under dirty conditions, neither antiseptic was effectively mycobactericidal (LR < 5). These preliminary findings caution against the universal replacement of PI with CHX as the first-line skin antiseptic, since all isolates were resistant to CHX. More studies are needed to establish the best practice for skin antisepsis if mycobacterial infections are also to be prevented.

Comparing the Utilities of Different Multilocus Sequence Typing Schemes for Identifying Outbreak Strains of Mycobacterium abscessus subsp. massiliense

“…Of 85 isolates evaluated, 57 isolates belonged to MMA1/ST48, with 100% agreement between the three MLST schemes (Table 3). Clear epidemiological links to the 2010-2012 outbreak by case definition of contaminated ultrasonography gel or invasive procedures were established for 51 of these MMA1/ST48 isolates (as published previously) (12,25,29). The remaining six MMA1/ST48 isolates exhibited identical PFGE patterns but did not fit the case definition of the contaminated ultrasonography gel or invasive procedures (Table 3).…”

Longitudinal non-cystic fibrosis trends of pulmonary Mycobacterium abscessus disease from 2010 to 2017: spread of the “globally successful clone” in Asia

“…As reported in outbreaks and non-outbreak studies among CF in the United States, United Kingdom, France, Ireland, Germany, Switzerland and Brazil, CC3 appears to be increasingly clinically prevalent among respiratory isolates of non-CF patients in Taiwan. These findings are likely to be explained by the environmental prevalence of CC3 that are more likely to infect humans, perhaps associated with their exceptional resistance to disinfectants such as alcoholic chlorhexidine and povidone iodine [ 41 ]. Novel features from this study include the prominence of ST48, which is closely related to ST23 and assigned to the same clonal complex 3, and the lower percentage of singleton isolates with new MLST types compared to the earlier MLST studies.…”

Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Staphylococcus aureus Decolonization

“…• • Several reports of the induction of CHG resistance but a low incidence in some studies (81,(84)(85)(86)(87)(88)(89)(90) Preoperative topical CHG in orthopedic surgery:…”