Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings
Abstract Background Hospital-acquired infections caused by multidrug resistant (MDR) Klebsiella pneumoniae pose a significant global health threat. Effective antisepsis and disinfection protocols are mandatory to prevent these infections. This study aimed to isolate Klebsiella pneumoniae, evaluate a...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12879-025-10980-w |
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| author | Amal F. Makled Azza Z. Labeeb Heba M. Moaz Asmaa S. Sleem |
| author_facet | Amal F. Makled Azza Z. Labeeb Heba M. Moaz Asmaa S. Sleem |
| author_sort | Amal F. Makled |
| collection | DOAJ |
| description | Abstract Background Hospital-acquired infections caused by multidrug resistant (MDR) Klebsiella pneumoniae pose a significant global health threat. Effective antisepsis and disinfection protocols are mandatory to prevent these infections. This study aimed to isolate Klebsiella pneumoniae, evaluate antimicrobial susceptibility, and assess the efficacy of selected biocides. Methods Fifty clinical MDR Klebsiella pneumoniae isolates were collected from various hospital departments. Antimicrobial susceptibility was determined using the disc diffusion method. Minimum inhibitory concentrations (MICs) of chlorhexidine and benzalkonium chloride were measured via agar dilution. Conventional PCR was employed to detect biocide resistance genes (qacE∆1 and cepA). Results Klebsiella pneumoniae was identified in 19.16% of cases. All isolates exhibited multidrug resistance, with multiple antimicrobial resistance indices ranging from 0.24 to 0.92, reaching up to 1. Benzalkonium chloride MICs significantly increased with resistance, reaching up to 64 µg/mL, while chlorhexidine MICs were consistent across isolates. The qacE∆1 and cepA genes were detected in 62% and 72% of isolates, respectively, with a significant association between qacE∆1 and cephalosporin resistance. No significant correlation was found between biocide MICs and clinical specimen types or hospital units. Conclusion The cepA gene is closely associated with extensive drug resistance in Klebsiella pneumoniae, emphasizing its role in antimicrobial resistance. Optimized biocide formulations, when properly developed and applied, can play a crucial role in combating and preventing infections caused by multidrug-resistant Klebsiella pneumoniae. |
| format | Article |
| id | doaj-art-ce123b5504a34be2a00d590807f1651b |
| institution | OA Journals |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-ce123b5504a34be2a00d590807f1651b2025-08-20T01:49:40ZengBMCBMC Infectious Diseases1471-23342025-05-0125111010.1186/s12879-025-10980-wChlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settingsAmal F. Makled0Azza Z. Labeeb1Heba M. Moaz2Asmaa S. Sleem3Department of Medical Microbiology & Immunology, Faculty of Medicine, Menoufia UniversityDepartment of Medical Microbiology & Immunology, Faculty of Medicine, Menoufia UniversityDepartment of Medical Microbiology & Immunology, Faculty of Medicine, Menoufia UniversityDepartment of Medical Microbiology & Immunology, Faculty of Medicine, Menoufia UniversityAbstract Background Hospital-acquired infections caused by multidrug resistant (MDR) Klebsiella pneumoniae pose a significant global health threat. Effective antisepsis and disinfection protocols are mandatory to prevent these infections. This study aimed to isolate Klebsiella pneumoniae, evaluate antimicrobial susceptibility, and assess the efficacy of selected biocides. Methods Fifty clinical MDR Klebsiella pneumoniae isolates were collected from various hospital departments. Antimicrobial susceptibility was determined using the disc diffusion method. Minimum inhibitory concentrations (MICs) of chlorhexidine and benzalkonium chloride were measured via agar dilution. Conventional PCR was employed to detect biocide resistance genes (qacE∆1 and cepA). Results Klebsiella pneumoniae was identified in 19.16% of cases. All isolates exhibited multidrug resistance, with multiple antimicrobial resistance indices ranging from 0.24 to 0.92, reaching up to 1. Benzalkonium chloride MICs significantly increased with resistance, reaching up to 64 µg/mL, while chlorhexidine MICs were consistent across isolates. The qacE∆1 and cepA genes were detected in 62% and 72% of isolates, respectively, with a significant association between qacE∆1 and cephalosporin resistance. No significant correlation was found between biocide MICs and clinical specimen types or hospital units. Conclusion The cepA gene is closely associated with extensive drug resistance in Klebsiella pneumoniae, emphasizing its role in antimicrobial resistance. Optimized biocide formulations, when properly developed and applied, can play a crucial role in combating and preventing infections caused by multidrug-resistant Klebsiella pneumoniae.https://doi.org/10.1186/s12879-025-10980-wKlebsiella pneumoniaeChlorhexidineBenzalkonium chlorideqacE∆1CepA |
| spellingShingle | Amal F. Makled Azza Z. Labeeb Heba M. Moaz Asmaa S. Sleem Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings BMC Infectious Diseases Klebsiella pneumoniae Chlorhexidine Benzalkonium chloride qacE∆1 CepA |
| title | Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings |
| title_full | Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings |
| title_fullStr | Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings |
| title_full_unstemmed | Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings |
| title_short | Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings |
| title_sort | chlorhexidine and benzalkonium chloride promising adjuncts in combating multidrug resistant klebsiella pneumoniae in healthcare settings |
| topic | Klebsiella pneumoniae Chlorhexidine Benzalkonium chloride qacE∆1 CepA |
| url | https://doi.org/10.1186/s12879-025-10980-w |
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