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Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis

Year 2015, , 162 - 166, 06.02.2016
https://doi.org/10.5799/ahinjs.02.2015.04.0198

Abstract

Objective: Biofilm formation of microorganisms on the surface of airways may lead to supraglottic colonization that may cause lower respiratuar tract infections. Studies searching the efficiency of local disinfectants on biofilm formation are limited. The aim of this study was to investigate the effects of chlorhexidine coated airways on biofilm formation of Staphylococcus epidermidis.

Methods: Culture and electron microscopy methods were used for biofilm assessment. Airways were divided into two groups to investigate the effects of chlorhexidine on number of bacteria attached to the airway and biofilm formation. Group 1(control): naive material, S. epidermidis, Group 2: chlorhexidine coated material, S. epidermidis. No process was applied in Group 1. Chlorhexidine gluconate (0.2%) was sprayed on the surface of naive material for four seconds and then left to dry in air, in Group to. Number of bacteria attached to the airway were counted by microbiological methods and biofilm formation was shown by Scanning Electron Microscope (SEM). Mann-Whitney u test was performed for statistical analyses.

Results: In Group 2, bacteria numbers were 1x102-8x102 cfu/ml, whereas they were 3x103-1x104 cfu/ml in Group 1. Chlorhexidine decreased number of microorganisms attached to the airways with statistical significance (p=0.04). The results of the electron microscopic evaluation were in accordance with the bacteriological findings.

Conclusion: This study has shown that chlorhexidine coating can successfully reduce the number of adhered bacteria and biofilm formation on airways. J Microbiol Infect Dis 2015;5(4): 162-166

Key words: Chlorhexidine; oral airway; biofilm; Staphylococcus epidermidis

References

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  • Houari A, DiMartino P. Effect of chlorhexidine and benzalkonium
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  • ;45:652-656.
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  • yeast and filamentous forms in an early-stage Candida albicans
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  • Berra L, De Marchi L, Yu ZX, et al. Endotracheal tubes coated
  • with antiseptics decrease bacterial colonization of the ventilator
  • circuits, lungs, and endotracheal tube. Anesthesiology 2008;100:1446-1456.
  • Feldman C, Kassel M, Cantrell J, et al. The presence and sequence
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  • mechanical ventilation. Eur Respir J 1999;13:546-551.
  • Atiyeh BS, Costagliola M, Hayek SN, Dibo SA. Effect of silver
  • on burn wound infection control and healing: Review of the
  • literatüre. Burns 2007;33:139-148.
  • Scannapieco FA, Yu J, Raghavendran K, et al. A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients. Crit Care 2009;13:R117.
  • Modesto A, Drake DR. Multiple exposures to chlorhexidine and xylitol: adhesion and biofilm formation by Streptococcus mutans. Curr Microbiol 2006;52:418-423.
  • Hope CK, Wilson M. Analysis of the effects of chlorhexidine
  • on oral biofilm vitality and structure based on viability profiling and an indicator of membrane integrity. AntimicrobAgents Chemother 2004;48:1461-1468.
  • Panchabhai TS, Dangayach NS, Krishnan A, et al. Oropharyngeal
  • cleansing with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: an open label randomized trial with 0.01% potassium permanganate as control. Chest 2009; 135:1150-1156.
  • Panchabhai TS, Dangayach NS. Role of chlorhexidine
  • gluconate in ventilator-associated pneumonia prevention
  • strategies in ICU patients: where are we headed? Crit Care
  • ;13:427.
  • Agalar C, Ozdogan M, Agalar F, et al. A rat model of olypropylene
  • graft infection caused by Staphylococcus epidermidis.ANZ J Surg 2006;76:387-391.
  • Clinical and Laboratory Standards Institute. Performance
  • Standards for Antimicrobial Susceptibility Testing: Nineteenth
  • Informational Supplement M100-S19. Wayne, PA,USA: CLSI; 2009.
  • Kilic D, Agalar C, Ozturk E, et al. Antimicrobial activity of cefazolin-impregnated mesh grafts. ANZ J Surg 2007;77:256-
  • -
  • Chaiban G, Hanna H, Dvorak T, Raad I. A rapid method of
  • impregnating endotracheal tubes and urinary catheters with
  • gendine: a novel antiseptic agent, J Antimicrob Chemother 2005;55:51-56.
  • Shen Y, Stojicic S, Haapasalo M. Antimicrobial efficacy of
  • chlorhexidine against bacteria in biofilms at different stages
  • of development. J Endod 2011;37:657-661.
  • Vitkov L, Hermann A, Krautgartner WD, et al. Chlorhexidineinduced ultrastructural alterations in oral biofilm. MicroscResTech 2005;68:85-89.
  • Saygun O, Agalar C, Aydinuraz K, et al. Gold and gold-palladium
  • coated polypropylene grafts in a S. epidermidis wound infection model. J Surg Res 2006;131:73-79.
  • Denkbaş EB, Oztürk E, Ozdemir N, et al. Norfloxacin-loaded
  • chitosan sponges as wound dressing material. J Biomater Appl 2004;18:291-303.
  • Agalar C, Kilic D, Ceken S. Inhibition of Staphylococcus
  • epidermidis colonization with fusidic acid-impregnated catheters.
  • J Bioact Compat Polym 2007;22:160-174.
  • Schwandt LQ, Van Weissenbruch R, Stokroos I, et al. Prevention
  • of biofilm formation by dairy products and N-acetylcysteine on voice prostheses in an artificial throat. Acta Otolaryngol 2004;124:726-731.
  • Raad II, Mohamed JA, Reitzel RA, et al.The prevention of biofilm
  • colonization by multidrug-resistant pathogens that cause ventilator-associated pneumonia with antimicrobial-coated
  • endotracheal tubes, Biomaterials 2011;32:2689-2694.

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Year 2015, , 162 - 166, 06.02.2016
https://doi.org/10.5799/ahinjs.02.2015.04.0198

Abstract

-

References

  • Safdar N, Crnich CJ, Maki DG. The pathogenesis of ventilatorassociated pneumonia: its relevance to developing effective
  • strategies for prevention. Respir Care 2005;50:725-739.
  • Houari A, DiMartino P. Effect of chlorhexidine and benzalkonium
  • chloride on bacterial biofilm formation. Lett Appl Microbiol
  • ;45:652-656.
  • Suci PA, Tyler BJ. Action of chlorhexidine digluconate against
  • yeast and filamentous forms in an early-stage Candida albicans
  • biofilm. Antimicrob Agents Chemother 2002;46:3522-3531.
  • Berra L, Curto F, LiBassi G, et al. Antimicrobial-coated ndotracheal
  • tubes: an experimental study. Intens Care Med 2008;34:1020-1029.
  • Berra L, De Marchi L, Yu ZX, et al. Endotracheal tubes coated
  • with antiseptics decrease bacterial colonization of the ventilator
  • circuits, lungs, and endotracheal tube. Anesthesiology 2008;100:1446-1456.
  • Feldman C, Kassel M, Cantrell J, et al. The presence and sequence
  • of endotracheal tube colonization in patients undergoing
  • mechanical ventilation. Eur Respir J 1999;13:546-551.
  • Atiyeh BS, Costagliola M, Hayek SN, Dibo SA. Effect of silver
  • on burn wound infection control and healing: Review of the
  • literatüre. Burns 2007;33:139-148.
  • Scannapieco FA, Yu J, Raghavendran K, et al. A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients. Crit Care 2009;13:R117.
  • Modesto A, Drake DR. Multiple exposures to chlorhexidine and xylitol: adhesion and biofilm formation by Streptococcus mutans. Curr Microbiol 2006;52:418-423.
  • Hope CK, Wilson M. Analysis of the effects of chlorhexidine
  • on oral biofilm vitality and structure based on viability profiling and an indicator of membrane integrity. AntimicrobAgents Chemother 2004;48:1461-1468.
  • Panchabhai TS, Dangayach NS, Krishnan A, et al. Oropharyngeal
  • cleansing with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: an open label randomized trial with 0.01% potassium permanganate as control. Chest 2009; 135:1150-1156.
  • Panchabhai TS, Dangayach NS. Role of chlorhexidine
  • gluconate in ventilator-associated pneumonia prevention
  • strategies in ICU patients: where are we headed? Crit Care
  • ;13:427.
  • Agalar C, Ozdogan M, Agalar F, et al. A rat model of olypropylene
  • graft infection caused by Staphylococcus epidermidis.ANZ J Surg 2006;76:387-391.
  • Clinical and Laboratory Standards Institute. Performance
  • Standards for Antimicrobial Susceptibility Testing: Nineteenth
  • Informational Supplement M100-S19. Wayne, PA,USA: CLSI; 2009.
  • Kilic D, Agalar C, Ozturk E, et al. Antimicrobial activity of cefazolin-impregnated mesh grafts. ANZ J Surg 2007;77:256-
  • -
  • Chaiban G, Hanna H, Dvorak T, Raad I. A rapid method of
  • impregnating endotracheal tubes and urinary catheters with
  • gendine: a novel antiseptic agent, J Antimicrob Chemother 2005;55:51-56.
  • Shen Y, Stojicic S, Haapasalo M. Antimicrobial efficacy of
  • chlorhexidine against bacteria in biofilms at different stages
  • of development. J Endod 2011;37:657-661.
  • Vitkov L, Hermann A, Krautgartner WD, et al. Chlorhexidineinduced ultrastructural alterations in oral biofilm. MicroscResTech 2005;68:85-89.
  • Saygun O, Agalar C, Aydinuraz K, et al. Gold and gold-palladium
  • coated polypropylene grafts in a S. epidermidis wound infection model. J Surg Res 2006;131:73-79.
  • Denkbaş EB, Oztürk E, Ozdemir N, et al. Norfloxacin-loaded
  • chitosan sponges as wound dressing material. J Biomater Appl 2004;18:291-303.
  • Agalar C, Kilic D, Ceken S. Inhibition of Staphylococcus
  • epidermidis colonization with fusidic acid-impregnated catheters.
  • J Bioact Compat Polym 2007;22:160-174.
  • Schwandt LQ, Van Weissenbruch R, Stokroos I, et al. Prevention
  • of biofilm formation by dairy products and N-acetylcysteine on voice prostheses in an artificial throat. Acta Otolaryngol 2004;124:726-731.
  • Raad II, Mohamed JA, Reitzel RA, et al.The prevention of biofilm
  • colonization by multidrug-resistant pathogens that cause ventilator-associated pneumonia with antimicrobial-coated
  • endotracheal tubes, Biomaterials 2011;32:2689-2694.
There are 55 citations in total.

Details

Primary Language English
Journal Section Brief Report
Authors

Ünase Büyükkoçak This is me

Canan Ağalar This is me

Turgut Deniz This is me

Sabahat Çeken This is me

Fatih Ağalar This is me

Publication Date February 6, 2016
Published in Issue Year 2015

Cite

APA Büyükkoçak, Ü., Ağalar, C., Deniz, T., Çeken, S., et al. (2016). Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis. Journal of Microbiology and Infectious Diseases, 5(4), 162-166. https://doi.org/10.5799/ahinjs.02.2015.04.0198
AMA Büyükkoçak Ü, Ağalar C, Deniz T, Çeken S, Ağalar F. Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis. J Microbil Infect Dis. February 2016;5(4):162-166. doi:10.5799/ahinjs.02.2015.04.0198
Chicago Büyükkoçak, Ünase, Canan Ağalar, Turgut Deniz, Sabahat Çeken, and Fatih Ağalar. “Effect of Chlorhexidine on Oral Airway Biofilm Formation of Staphylococcus Epidermidis”. Journal of Microbiology and Infectious Diseases 5, no. 4 (February 2016): 162-66. https://doi.org/10.5799/ahinjs.02.2015.04.0198.
EndNote Büyükkoçak Ü, Ağalar C, Deniz T, Çeken S, Ağalar F (February 1, 2016) Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis. Journal of Microbiology and Infectious Diseases 5 4 162–166.
IEEE Ü. Büyükkoçak, C. Ağalar, T. Deniz, S. Çeken, and F. Ağalar, “Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis”, J Microbil Infect Dis, vol. 5, no. 4, pp. 162–166, 2016, doi: 10.5799/ahinjs.02.2015.04.0198.
ISNAD Büyükkoçak, Ünase et al. “Effect of Chlorhexidine on Oral Airway Biofilm Formation of Staphylococcus Epidermidis”. Journal of Microbiology and Infectious Diseases 5/4 (February 2016), 162-166. https://doi.org/10.5799/ahinjs.02.2015.04.0198.
JAMA Büyükkoçak Ü, Ağalar C, Deniz T, Çeken S, Ağalar F. Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis. J Microbil Infect Dis. 2016;5:162–166.
MLA Büyükkoçak, Ünase et al. “Effect of Chlorhexidine on Oral Airway Biofilm Formation of Staphylococcus Epidermidis”. Journal of Microbiology and Infectious Diseases, vol. 5, no. 4, 2016, pp. 162-6, doi:10.5799/ahinjs.02.2015.04.0198.
Vancouver Büyükkoçak Ü, Ağalar C, Deniz T, Çeken S, Ağalar F. Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis. J Microbil Infect Dis. 2016;5(4):162-6.