povidone-iodine and Klebsiella-Infections

The role of mrkA adhesin expression, biofilm production, biofilm viability and biocides in the biofilm of carbapenemase-producing Klebsiella pneumoniae isolates was investigated.. Seventeen isolates representing different sequence types and carbapenemases were investigated. mrkA expression was determined by real-time reverse transcription polymerase chain reaction. Biofilm production (25°C and 37°C, with and without humidity) was determined by the crystal violet assay. The effect of isopropanol, povidone-iodine, sodium hypochlorite, chlorhexidine digluconate, benzalkonium chloride, ethanol and triclosan on biofilm was determined. The effect of povidone-iodine on biofilm biomass and thickness was also determined by confocal laser scanning microscopy.. mrkA expression ranged from 28.2 to 1.3 [high or intermediate level; 64% of high-risk (HR) clones] and from 21.5 to 1.3 (50% of non-HR clones). At 25°C, biofilm formation was observed in 41% of isolates (absence of humidity) and 35% of isolates (presence of humidity), whereas at 37°C, biofilm formation was observed in 76% of isolates with and without humidity. At 25°C, biofilm producers were more frequently observed in HR clones (45% with humidity and 55% without humidity) than non-HR clones (17% with and without humidity). Biofilm viability from day 21 was higher at 25°C than 37°C. The greatest decrease in biofilm formation was observed with povidone-iodine (29% decrease), which also decreased biofilm thickness.. Biofilm formation in carbapenemase-producing K. pneumoniae is related to mrkA expression. Biofilm formation is affected by temperature (37°C>25°C), whereas humidity has little effect. Biofilm viability is affected by temperature (25°C>37°C). At 25°C, HR clones are more frequently biofilm producers than non-HR clones. Povidone-iodine can decrease biofilm production and biofilm thickness.

Topics: 2-Propanol; Anti-Bacterial Agents; Bacterial Proteins; Benzalkonium Compounds; beta-Lactamases; Biofilms; Carbapenem-Resistant Enterobacteriaceae; Clone Cells; Disinfectants; Ethanol; Gentian Violet; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Operon; Povidone-Iodine; Prevalence; Sodium Hypochlorite; Triclosan

Carbapenem-resistant Enterobacteriaceae (CRE) infections have become a global health threat. Controlling CRE transmission in hospitals is increasingly dependent on the use of disinfectants to restrict the risk of infection. Here, the susceptibility of patient-derived carbapenem resistant Klebsiella pneumoniae (CRKP) and Escherichia coli (CREC) strains against three common disinfectants and the determinants of resistance to disinfectants were investigated.. The minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of three common chemical disinfectants: chlorhexidine, trichloroisocyanuric (TCCA) acid and Povidone iodine (PVP-I) against 50 CRE strains were measured. The drug-resistance genes -qacEΔ1, qacA/B and cepA-were determined using polymerase chain reaction.. CRE strains collected from patients in our hospital exhibit various degree of resistance to the commonly used chemical disinfectants. It is of great help to keep monitoring the tendency of the reduced susceptibility of the pan-resistant strains against disinfectants, in order to effectively control and prevent the spread of the super resistant bacteria.

Topics: Anti-Bacterial Agents; Carbapenem-Resistant Enterobacteriaceae; China; Chlorhexidine; Disinfectants; Drug Resistance, Bacterial; Escherichia coli; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Povidone-Iodine; Tertiary Care Centers; Triazines

During 11 months 58 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-Kp) isolates were grown from 10 patients on a neurological early rehabilitation unit. The patients had no signs of infection but were colonized in the nose and trachea, and unusually only one had colonization in the gut. A single clone of ESBL-Kp was identified by pulse field gel electrophoresis. Strong hygienic precautions similar to those for Methicillin-resistant Staphylococcus aureus patients prevented spread of the bacteria to other wards. However, rehabilitation for patients with severe neurological failures made it very difficult to follow hygienic requirements. Disinfection of mucous membranes was difficult. Eventually the application of a nasal spray containing povidone-iodine proved to be successful.

Topics: Anti-Infective Agents, Local; beta-Lactamases; Carrier State; Cross Infection; Drug Resistance, Microbial; Environmental Microbiology; Humans; Infection Control; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Nose; Physical Therapy Department, Hospital; Povidone-Iodine; Trachea

Two patients aged 2 months and 9 days with postoperative mediastinal infection were treated by continuous closed irrigation with 0.5% povidone-iodine solution. Satisfactory eradication was achieved in both two patients. Although serum iodine level was elevated as high as 7,610 micrograms/dl in the neonatal patient, no disturbances of the thyroid function and the acid-base balance were seen. The usefulness of continuous closed irrigation in the neonatal or infantile period was suggested.

Topics: Cardiac Surgical Procedures; Female; Humans; Infant; Klebsiella Infections; Mediastinitis; Postoperative Complications; Povidone; Povidone-Iodine; Therapeutic Irrigation

Topics: Aged; Bacterial Infections; Cardiac Surgical Procedures; Child, Preschool; Enterobacter; Enterobacteriaceae Infections; Escherichia coli Infections; Female; Humans; Infant; Klebsiella Infections; Male; Mediastinal Diseases; Middle Aged; Povidone; Povidone-Iodine; Proteus Infections; Pseudomonas Infections; Serratia; Staphylococcal Infections; Sternum; Streptococcal Infections; Surgical Wound Infection; Therapeutic Irrigation

Topics: Administration, Topical; Adolescent; Adult; Aged; Burns; Candidiasis; Child; Child, Preschool; Escherichia coli Infections; Female; Humans; Infant; Infection Control; Klebsiella Infections; Male; Middle Aged; Ointments; Povidone; Povidone-Iodine; Proteus Infections; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections