A global 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. Printed in The Lancet Microbe, the examine requires a reassessment of well being care pointers on the widespread use of disinfectants.
“Our analysis highlights the unintended penalties of common decolonization in a worldwide context the place antibiotic resistance is an growing menace,” 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 stop antibiotic-resistant infections are essential, however they have to not forestall us from critically re-evaluating the instruments we use to attain these targets.”
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 units and hospital surfaces—and an extra nasal therapy is run with one other disinfectant, mupirocin.
Launched within the Nineteen Nineties, the process has confirmed efficient in curbing the unfold of MRSA (Methicillin-Resistant Staphylococcus aureus), a bacterium proof against sure antibiotics that may trigger extreme infections.
For a number of years, using common decolonization lowered MRSA an infection charges from 30%–40% to beneath 5% in lots of nations, together with Scotland, the place this examine was performed. The state of affairs is totally different in Italy, the place knowledge from the Istituto Superiore di Sanità nonetheless point out a 26% MRSA prevalence.
“At present, UK well being care services take totally different approaches: some hospitals apply common decolonization to all sufferers, whereas others take a extra focused method, decolonizing solely those that take a look at optimistic for MRSA,” Oggioni explains. “Consequently, hospitals adopting common decolonization use considerably bigger volumes of disinfectants comparable to 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 attributable to 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 proof against a number of varieties of antibiotics.
“Our findings present that the extreme use of disinfectants in common decolonization could not enhance an infection management, and as a substitute results in an increase in MRSE infections,” confirms Professor Hijazi, who coordinated the examine. “In intensive care settings the place the danger of MRSA an infection is low, indiscriminate use of decolonization procedures could not solely be ineffective but in addition probably dangerous.”
“This is applicable to areas the place MRSA prevalence is low, like Scotland,” Oggioni provides. “In Italy, nonetheless, MRSA an infection danger stays excessive regardless of a downward development, which implies each focused and common decolonization are nonetheless crucial. We’ll want to scale back MRSA prevalence in Italy earlier than we are able to reassess the dangers and advantages of those intervention procedures.”
The examine’s authors due to this fact name for a reassessment of present practices in gentle of the evolving epidemiological panorama. New standardized pointers are wanted to determine the simplest decolonization therapies, weighing each the advantages in an infection management and the potential impression 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 elevate danger of antibiotic-resistant infections (2025, June 13)
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