Chlorhexidine use, intensive care exercise, and bloodstream an infection aetiological profile over the examine interval. Credit score: The Lancet Microbe (2025). DOI: 10.1016/j.lanmic.2025.101118
A world examine has, for the primary time, revealed a robust and direct hyperlink between the rise of antibiotic-resistant micro organism and common disinfection procedures utilized to sufferers in intensive care items. Revealed in The Lancet Microbe, the examine requires a reassessment of well being care tips on the widespread use of disinfectants.
“Our research highlights the unintended consequences of universal decolonization in a global context where antibiotic resistance is an increasing threat,” says Marco Oggioni, professor on the Division of Pharmacy and Biotechnology on the College of Bologna and one of many examine’s authors. “Coordinated efforts to prevent antibiotic-resistant infections are crucial, but they must not prevent us from critically re-evaluating the tools we use to achieve these goals.”
Common decolonization is a preventive process utilized to sufferers upon admission to intensive care. Your complete physique is disinfected with chlorhexidine—a generally used antiseptic additionally employed to sanitize medical gadgets and hospital surfaces—and an extra nasal remedy is run with one other disinfectant, mupirocin.
Launched within the Nineties, the process has confirmed efficient in curbing the unfold of MRSA (Methicillin-Resistant Staphylococcus aureus), a bacterium immune to sure antibiotics that may trigger extreme infections.
For a number of years, using common decolonization diminished MRSA an infection charges from 30%–40% to beneath 5% in lots of international locations, together with Scotland, the place this examine was performed. The scenario is totally different in Italy, the place information from the Istituto Superiore di Sanità nonetheless point out a 26% MRSA prevalence.
“Currently, UK health care facilities take different approaches: some hospitals apply universal decolonization to all patients, while others take a more targeted approach, decolonizing only those who test positive for MRSA,” Oggioni explains. “As a result, hospitals adopting universal decolonization use significantly larger volumes of disinfectants such as chlorhexidine and mupirocin.”
Specializing in two Scottish hospitals utilizing these totally different approaches, the researchers in contrast bacterial an infection ranges and antibiotic resistance charges amongst intensive care sufferers over a 13-year interval.
The outcomes confirmed larger charges of an infection brought on by the superbug MRSE (Methicillin-Resistant Staphylococcus epidermidis) within the hospital practising common decolonization. MRSE is much less well-known than MRSA however is more and more widespread and immune to a number of varieties of antibiotics.
“Our findings show that the excessive use of disinfectants in universal decolonization may not improve infection control, and instead leads to a rise in MRSE infections,” confirms Professor Hijazi, who coordinated the examine. “In intensive care settings where the risk of MRSA infection is low, indiscriminate use of decolonization procedures may not only be ineffective but also potentially harmful.”
“This applies to regions where MRSA prevalence is low, like Scotland,” Oggioni provides. “In Italy, however, MRSA infection risk remains high despite a downward trend, which means both targeted and universal decolonization are still necessary. We’ll need to reduce MRSA prevalence in Italy before we can reassess the risks and benefits of these intervention procedures.”
The examine’s authors due to this fact name for a reassessment of present practices in mild of the evolving epidemiological panorama. New standardized tips are wanted to establish the best decolonization therapies, weighing each the advantages in an infection management and the potential influence on antibiotic resistance.
Extra info:
Sara Sharaf et al, Common versus focused chlorhexidine and mupirocin decolonisation and medical and molecular epidemiology of Staphylococcus epidermidis bloodstream infections in sufferers in intensive care in Scotland, UK: a managed time-series and longitudinal genotypic examine, The Lancet Microbe (2025). DOI: 10.1016/j.lanmic.2025.101118
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Extreme use of disinfectants in intensive care sufferers could increase threat of antibiotic-resistant infections (2025, June 13)
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