Chlorhexidine Does Not Select for Resistance in Staphylococcus aureus Isolates in a Community Setting

This is the authors' abstract. We don't add key points for this paper.

Chlorhexidine Does Not Select for Resistance in Staphylococcus aureus Isolates in a Community SettingTo the Editor-Chlorhexidine gluconate (CHG) is used in decolonization protocols to prevent invasive Staphylococcus aureus disease in hospital and community settings. 1,2Earlier reports have described CHG-resistant S. aureus in hospitals, yet evidence of this trend in the community is lacking. 3,4 cluster-randomized, double-blind controlled trial evaluating the effectiveness of 2% CHG body cloths (Sage Products) versus control cloths (Comfort Bath [CB] nonmedicated cleaning cloths; Sage Products) in reducing the incidence of skin and soft-tissue infection (SSTI) was performed in a cohort of military recruits. 5Subjects used 2 cloths to cleanse their body 3 times per week.Nasal and axillary body sites were screened for S. aureus colonization at baseline and every 2 weeks thereafter during 6 weeks of training.Although CHG did not reduce the incidence of SSTI, it did decrease incident S. aureus colonization.The substudy presented here evaluated the incidence of CHG-resistant S. aureus colonization among these recruits after repeated exposure.Among subjects assigned to the CHG group, those that were persistently colonized (ie, had results positive for S. aureus in nares and/or axilla at baseline and at each biweekly visit) and reported using greater than or equal to 50% of cloths met criteria for evaluation and had each isolate assessed for CHG resistance.The same criteria were used for selection of subjects assigned to the CB group.A random subset of recruits were selected from among subjects in the CB group who met the criteria, and the baseline and last positive biweekly isolates were assessed for CHG resistance.CHG minimum inhibitory concentration (MIC) was determined using the agar dilution method and incorporated the use of a 3-mm Steers Replicator. 6An ATCC #29213 S. awrew5-positive control with a CHG MIC of 2 jug/mL was used to ensure an expected range of MICs.