Multidrug-resistant (MR) Gram-negative (GN) pathogens pose a major and growing threat for healthcare systems, as therapy of infections is often limited due to the lack of available systemic antibiotics. Well-tolerated antiseptics, such as octenidine dihydrochloride (OCT), may be a very useful tool in infection control to reduce the dissemination of MRGN. This study aimed to investigate the bactericidal activity of OCT against international epidemic clones of MRGN. A set of five different species (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii, and Pseudomonas aeruginosa) was studied to prove OCT efficacy without organic load, under “clean conditions” (0.3 g/L albumin) and under “dirty conditions” (3 g/L albumin + 3 mL/L defibrinated sheep blood), according to an official test norm (EN13727). We used five clonally unrelated isolates per species, including a susceptible wild-type strain, and four MRGN isolates, corresponding to either the 3MRGN or 4MRGN definition of multidrug resistance. A contact time of 1 min was fully effective for all isolates by using different OCT concentrations (0.01% and 0.05%), with a bacterial reduction factor of >5 log10 systematically observed. Growth kinetics were determined with two different wild-type strains (A. baumannii and K. pneumoniae), proving a time-dependent efficacy of OCT. These results highlight that OCT may be extremely useful to eradicate emerging highly resistant Gram-negative pathogens associated with nosocomial infections.
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This study was partially supported by Schülke & Mayr GmbH and the University of Fribourg. Active compounds were provided by Schülke & Mayr GmbH, Norderstedt, Germany.
Conflict of interest
L.P. received honoraria from Schülke & Mayr GmbH as a speaker for presenting data resulting from this study in international conferences.
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Alvarez-Marin, R., Aires-de-Sousa, M., Nordmann, P. et al. Antimicrobial activity of octenidine against multidrug-resistant Gram-negative pathogens. Eur J Clin Microbiol Infect Dis 36, 2379–2383 (2017). https://doi.org/10.1007/s10096-017-3070-0
- Multidrug-resistant Gram-negative Pathogens
- Octenidine Dihydrochloride
- Dirty Conditions
- Defibrinated Sheep Blood
- Time-dependent Efficacy