Prevalence of chlorhexidine-resistant methicillin-resistant Staphylococcus aureus following prolonged exposure

Carey D. Schlett, Eugene V. Millar, Katrina B. Crawford, Tianyuan Cui, Jeffrey B. Lanier, David R. Tribble, Michael W. Ellis

Research output: Contribution to journalArticle

Abstract

Chlorhexidine has been increasingly utilized in outpatient settings to control methicillin-resistant Staphylococcus aureus (MRSA) outbreaks and as a component of programs for MRSA decolonization and prevention of skin and soft-tissue infections (SSTIs). The objective of this study was to determine the prevalence of chlorhexidine resistance in clinical and colonizing MRSA isolates obtained in the context of a community-based cluster-randomized controlled trial for SSTI prevention, during which 10,030 soldiers were issued chlorhexidine for body washing. We obtained epidemiological data on study participants and performed molecular analysis of MRSA isolates, including PCR assays for determinants of chlorhexidine resistance and high-level mupirocin resistance and pulsed-field gel electrophoresis (PFGE). During the study period, May 2010 to January 2012, we identified 720 MRSA isolates, of which 615 (85.4%) were available for molecular analysis, i.e., 341 clinical and 274 colonizing isolates. Overall, only 10 (1.6%) of 615 isolates were chlorhexidine resistant, including three from the chlorhexidine group and seven from nonchlorhexidine groups (P>0.99). Five (1.5%) of the 341 clinical isolates and five (1.8%) of the 274 colonizing isolates harbored chlorhexidine resistance genes, and four (40%) of the 10 possessed genetic determinants for mupirocin resistance. All chlorhexidine-resistant isolates were USA300. The overall prevalence of chlorhexidine resistance in MRSA isolates obtained from our study participants was low. We found no association between extended chlorhexidine use and the prevalence of chlorhexidineresistant MRSA isolates; however, continued surveillance is warranted, as this agent continues to be utilized for infection control and prevention efforts.

Original languageEnglish (US)
Pages (from-to)4404-4410
Number of pages7
JournalAntimicrobial Agents and Chemotherapy
Volume58
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

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Chlorhexidine
Methicillin-Resistant Staphylococcus aureus
Mupirocin
Soft Tissue Infections
Skin
Pulsed Field Gel Electrophoresis
Military Personnel
Infection Control
Disease Outbreaks
Outpatients
Randomized Controlled Trials
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Infectious Diseases
  • Medicine(all)

Cite this

Schlett, C. D., Millar, E. V., Crawford, K. B., Cui, T., Lanier, J. B., Tribble, D. R., & Ellis, M. W. (2014). Prevalence of chlorhexidine-resistant methicillin-resistant Staphylococcus aureus following prolonged exposure. Antimicrobial Agents and Chemotherapy, 58(8), 4404-4410. https://doi.org/10.1128/AAC.02419-14

Prevalence of chlorhexidine-resistant methicillin-resistant Staphylococcus aureus following prolonged exposure. / Schlett, Carey D.; Millar, Eugene V.; Crawford, Katrina B.; Cui, Tianyuan; Lanier, Jeffrey B.; Tribble, David R.; Ellis, Michael W.

In: Antimicrobial Agents and Chemotherapy, Vol. 58, No. 8, 2014, p. 4404-4410.

Research output: Contribution to journalArticle

Schlett, CD, Millar, EV, Crawford, KB, Cui, T, Lanier, JB, Tribble, DR & Ellis, MW 2014, 'Prevalence of chlorhexidine-resistant methicillin-resistant Staphylococcus aureus following prolonged exposure', Antimicrobial Agents and Chemotherapy, vol. 58, no. 8, pp. 4404-4410. https://doi.org/10.1128/AAC.02419-14
Schlett, Carey D. ; Millar, Eugene V. ; Crawford, Katrina B. ; Cui, Tianyuan ; Lanier, Jeffrey B. ; Tribble, David R. ; Ellis, Michael W. / Prevalence of chlorhexidine-resistant methicillin-resistant Staphylococcus aureus following prolonged exposure. In: Antimicrobial Agents and Chemotherapy. 2014 ; Vol. 58, No. 8. pp. 4404-4410.
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