Pseudomonas Cepacia Resistance to Antibacterials

Richards, R. M. E.; Richards, J

doi:10.1002/jps.2600681127

Cited by 10 publications

(7 citation statements)

References 31 publications

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“…At chlorhexidine concentrations of 20 g/ml or more, a bactericidal effect can be expected as well as activity against yeasts (487). The actual effective concentration against Burkholderia cepacia and S. aureus varies with different supplements from 0.004 to 0.4% (factor 100), and the actual killing time also varies with different supplements (phenylethanol or edetate disodium) from Ͻ15 min to Ͼ360 min (465). In most studies, concentrations for rapid inactivation are well in excess of MICs, e.g., for S. aureus (103), E. coli, Vibrio cholerae (237), and yeasts (214).…”

Section: Chlorhexidinementioning

confidence: 99%

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

2004

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The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data from comparative trials are available to reliably rank triclosan. Personnel should be reminded that it is neither necessary nor recommended to routinely wash hands after each application of an alcohol-based hand rub. Long-lasting improvement of compliance with hand hygiene protocols can be successful if an effective and accessible alcohol-based hand rub with a proven dermal tolerance and an excellent user acceptability is supplied, accompanied by education of health care workers and promotion of the use of the product

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Section: Chlorhexidinementioning

confidence: 99%

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

2004

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“…Chemical antibacterial agents such as quaternary ammonium compounds are effective against P. cepacia only at high concentrations. Resistance to these compounds is increased even further by the addition of the chelating agent EDTA (36) and by depletion of magnesium in the culture medium (10). This is opposite from the effects of divalent cations on the outer membrane of other gram-negative bacteria including P. aeruginosa, E. coli, and Salmonella species (18).…”

Section: Discussionmentioning

confidence: 98%

Chloramphenicol resistance in Pseudomonas cepacia because of decreased permeability

Burns

Hedin

Lien

1989

Antimicrob Agents Chemother

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The mechanism of chloramphenicol resistance was examined in a high-level-resistant isolate of Pseudomonas cepacia from a patient with cystic fibrosis. We investigated potential resistance mechanisms, including production of chloramphenicol acetyltransferase, ribosomal resistance, and decreased permeability. This strain (MIC, 200 ,ug/ml) had no detectable chloramphenicol acetyltransferase activity. In in vitro translation experiments in which we compared the resistant isolate with a susceptible strain of P. cepacia, inhibition of amino acid incorporation was equivalent even in organisms that were preincubated with sub-MICs of chloramphenicol. A 21.9-kilobase (kb) fragment of DNA was cloned which coded for chloramphenicol resistance; this fragment was expressed in P. cepacia but not in Escherichia coli. Quantitation of chloramphenicol uptake in the isogenic pair of susceptible and resistant organisms revealed a nearly 10-fold decrease of drug entry into the resistant strain. Comparison of isolated outer membrane proteins and lipopolysaccharide patterns identified no significant differences between the isogenic pair of organisms. We concluded that the mechanism of chloramphenicol resistance in this strain is decreased permeability.Pseudomonas cepacia is an important nosocomial pathogen and an organism that can cause severe pulmonary infections in children and young adults with cystic fibrosis (CF). Originally recognized as a plant pathogen in 1950 (5), the role of P. cepacia in hospital-acquired infections of the urine, lungs, and bloodstream was first reported in the early 1970s (12,19,22,28,35). Colonization with P. cepacia occurs late in the course of pulmonary disease in patients with CF, and in several CF centers, outbreaks of virulent strains have resulted in severe and overwhelming pneumonia in a subpopulation of patients (21, 37).The major problem in the treatment of infections caused by P. cepacia is multiple antibiotic resistance. Isolates from patients with CF, in particular, are often highly resistant to the P-lactam agents and aminoglycosides that are used to treat Pseudomonas aeruginosa (4, 9, 15). Antibiotics with clinical efficacy against P. cepacia include chloramphenicol, trimethoprim, and the quinolones (12,21,28). However, more than half of clinical isolates may be resistant to these agents as well. Investigations of chloramphenicol resistance in P. cepacia strains from patients with CF consistently report that 45 to 50% of isolates are resistant (MIC,.10 ,ug/ml).In this report we describe the characterization of chloramphenicol resistance in P. cepacia. We used an isolate of P. cepacia from a patient with CF; this isolate was resistant to chloramphenicol, trimethoprim, and ciprofloxacin, as well as all P-lactams and aminoglycosides tested, and was selected to characterize the resistance mechanism. We cloned a 21.9-kilobase (kb) DNA fragment that encoded resistance to chloramphenicol in P. cepacia but that was not expressed in Escherichia coli. Potential mechanisms of resistance, including enzy...

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“…Resistance of Ps. cepacia to benzalkonium chloride, as well as to polymyxin B sulphate and chlorhexidine gluconate, has been studied by Richards & Richards (1979). Electron microscopy of the effect of these three agents on the cytoplasmic membrane has been performed by Richards & Cavil1 (1980).…”

Section: Discussionmentioning

confidence: 99%

The identification ofPseudomonas cepaciaand its occurrence in clinical material

Holmes¹

1986

Journal of Applied Bacteriology

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During the 19 year period ending December 1984, 4840 strains of Gram-negative non-fermentative bacteria were submitted to the National Collection of Type Cultures for identification. Of these, 195 strains (4.0% of the total) were identified as Pseudomonas cepacia which demonstrates both that the species is regularly encountered in clinical material in the UK and that several laboratories have experienced difficulty in identifying the organism. The sources from which the 195 strains were isolated are reported and also the characteristics by which the species may be recognized. The clinical significance of Ps. cepacia is reviewed, and the resistance of this species to disinfectants and antimicrobial agents commonly used to treat pseudomonas infections is discussed to underline the necessity for the precise identification of Ps. cepacia.

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Pseudomonas Cepacia Resistance to Antibacterials

Cited by 10 publications

References 31 publications

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

Chloramphenicol resistance in Pseudomonas cepacia because of decreased permeability

The identification ofPseudomonas cepaciaand its occurrence in clinical material

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