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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Main Authors: Amal F. Makled, Azza Z. Labeeb, Heba M. Moaz, Asmaa S. Sleem
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Infectious Diseases
Subjects:
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.
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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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