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Polihekzametilen Biguanid'in (PHMB) Çoklu İlaç Dirençli ve Standart Bakteri İzolatlarına Karşı Antibakteriyel Etkinliğinin Araştırılması

Year 2025, Volume: 8 Issue: 3, 163 - 167, 28.10.2025
https://doi.org/10.26650/JARHS2025-1680666

Abstract

Amaç: Sağlık kuruluşlarında çoklu ilaca dirençli (ÇİD) bakteri suşlarının artışı, enfeksiyon yönetimi için önemli bir zorluk oluşturmaktadır. Yeni nesil bir antiseptik olan polihekzametilen biguanid (PHMB), düşük sitotoksisite ve çevresel güvenliğin yanı sıra geniş spektrumlu antimikrobiyal aktivite sunmaktadır. Bu çalışma, PHMB'nin hem standart bakteri suşlarına hem de klinik izolatlara karşı antibakteriyel etkinliğini, özellikle uzun vadeli inhibitör etkileri ve konsantrasyona bağlı aktivitesine odaklanarak değerlendirmeyi amaçlamaktadır.

Gereç ve Yöntemler: Beş standart bakteri suşu ve beş klinik izolat, 14 günlük bir süre boyunca günlük olarak %0,01, %0,1, %0,25, %0,5 ve %1 konsantrasyonlarında PHMB'ye maruz bırakılmıştır. 1, 2, 5, 10 ve 30 dakikalık maruziyet sürelerinin ardından koloni oluşturan birimler (CFU) sayımları yapıldı ve tüm suşlar için minimum bakterisidal konsantrasyonlar (MBC) belirlendi.

Bulgular: PHMB, test edilen tüm suşlara karşı güçlü antibakteriyel aktivite gösterdi. %0,1 ve üzeri konsantrasyonlar, 14 günlük süre boyunca tam büyüme inhibisyonu sağladı. Ancak, en düşük konsantrasyonda (%0,01), Acinetobacter baumannii ve Enterococcus faecalis için 10. günden itibaren yeniden büyüme gözlendi. Tüm konsantrasyonlarda, maruziyetin ilk 5 ila 10 dakikasında CFU sayılarında önemli azalmalar kaydedildi.

Sonuç: PHMB, düşük konsantrasyonlarda bile hem standart bakteri suşlarına hem de klinik izolatlara karşı hızlı ve güçlü antibakteriyel aktivite gösterdi. Düşük konsantrasyonlardaki etkinliği, sitotoksisiteyi ve çevresel etkiyi azaltma açısından önemli avantajlar sağlamaktadır. PHMB'nin klinik potansiyelinin tam olarak ortaya çıkarılması için dozaj rejimlerini optimize edilmesi, direnç gelişimi risklerinin belirlenmesi ve uzun vadeli güvenliğini değerlendirilmesi amacıyla daha fazla çalışmaya ihtiyaç vardır.

References

  • Pringle J. Observations on the diseases of the army in Camp and Garrison: in three volumes. Google Books; 1764. Available at: https://books.google.com. tr/books?id=-C4SjB8WSQIC&printsec=frontcover&source=gbs_ge_summary_r& cad=0#v=onepage&q&f=false. google scholar
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  • Kamaruzzaman NF, Firdessa R, Good L. Bactericidal effects of polyhexamethylene biguanide against intracellular Staphylococcus aureus EMRSA-15 and USA 300. J Antimicrob Chemother 2016;71(5):1252-9. google scholar
  • Krebs FC, Miller SR, Ferguson ML, Labib M, Rando RF, Wigdahl B. Polybiguanides, particularly polyethylene hexamethylene biguanide, have activity against human immunodeficiency virus type 1. Biomed Pharmacother 2005;59(8):438-45. google scholar
  • Donlan RM. Biofilms and device-associated infections. Emerg Infect Dis 2001;7(2):277-81. google scholar
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  • Machuca J, Lopez-Rojas R, Fernandez-Cuenca F, Pascual Á. Comparative activity of a polyhexanide-betaine solution against biofilms produced by multidrugresistant bacteria belonging to high-risk clones. J Hosp Infect 2019;103:e92-e96. google scholar
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  • Mashat BH. Polyhexamethylene biguanide hydrochloride: Features and applications. Int J Environ Sci 2016;4(1):49-55. google scholar
  • Niro A, Pignatelli F, Fallico M, Sborgia A, Passidomo F, Gigliola S, et al. Polyhexamethylene biguanide hydrochloride (PHMB)-properties and application of an antiseptic agent. A narrative review. Eur J Ophthalmol 2022;11206721221124684. google scholar
  • Sripriya R, Jayaraj G. Biocompatibility and efficiency of polyhexamethylene biguanide-based antiseptic dressings in wound management. J Wound Care 2018;27(9):630-7. google scholar
  • Montemezzo M, Ferrari MD, Kerstner E, Santos VD, Victorazzi Lain V, Wollheim C, et al. PHMB-loaded PDMS and its antimicrobial properties for biomedical applications. J Biomater Appl 2021;36(2):252-63. google scholar
  • Cooper RA. Polyhexamethylene biguanide (PHMB): antibacterial activity and clinical applications. J Antimicrobial Chemotherapy 2004;53(4):549-51. google scholar
  • Moore M, Gray D. Evaluation of the antimicrobial efficacy of PHMB formulations at low concentrations. J Hospital Infect 2007;65(1):41-7. google scholar
  • Sutton JM, Olson ME. Polyhexamethylene biguanide (PHMB) as an antimicrobial agent in wound care: a review. Int J Antimicrobial Agents 2013;42(2):143-50. google scholar
  • Hardy K, Sunnucks K, Gil H, Shabir S, Trampari E, Hawkey P, et al. Increased Usage of Antiseptics Is Associated with Reduced Susceptibility in Clinical Isolates of Staphylococcus aureus. mBio 2018;9(3):e00894-18. google scholar
  • LaBreck PT, Bochi-Layec AC, Stanbro J, Dabbah-Krancher G, Simons MP, Merrell DS. Systematic Analysis of Efflux Pump-Mediated Antiseptic Resistance in Staphylococcus aureus Suggests a Need for Greater Antiseptic Stewardship. mSphere 2020;5(1):e00959-19. google scholar
  • Davis SC, Harding A, Gil J, Parajon F, Valdes J, Solis M, et al. Effectiveness of a polyhexanide irrigation solution on methicillin-resistant Staphylococcus aureus biofilms in a porcine wound model. Int Wound J 2017;14(6):937-44. google scholar
  • Alves PJ, Barreto RT, Barrois BM, Gryson LG, Meaume S, Monstrey SJ. Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm. Int Wound J 2021;18(2):342-58. google scholar

Investigation of the Antibacterial Activity of Polyhexamethylene Biguanide (PHMB) Against Multidrug-Resistant and Standard Bacterial Isolates

Year 2025, Volume: 8 Issue: 3, 163 - 167, 28.10.2025
https://doi.org/10.26650/JARHS2025-1680666

Abstract

Objective: The rise of multidrug-resistant (MDR) bacterial strains in healthcare facilities presents a significant challenge for infection management. Polyhexamethylene biguanide (PHMB), a next generation antiseptic, offers broad-spectrum antimicrobial activity in addition to low cytotoxicity and environmental safety. This study aimed to evaluate the antibacterial efficacy of PHMB against both standard bacterial strains and clinical isolates, with a focus on its long-term inhibitory effects and concentration-dependent activity.

Material and Methods: Five standard bacterial strains and five clinical isolates were exposed daily to PHMB at concentrations of 0.01%, 0.1%, 0.25%, 0.5%, and 1% over a 14-day period. Colonyforming units (CFU) were quantified following exposure durations of 1, 2, 5, 10, and 30 min, and minimum bactericidal concentrations (MBC) were determined for all strains.

Results: PHMB demonstrated potent antibacterial activity against all tested strains. Concentrations of 0.1% achieved complete growth inhibition throughout the 14-day period. However, at the lowest concentration (0.01%), regrowth was observed from day 10 onward for Acinetobacter baumannii and Enterococcus faecalis. Significant reductions in CFU counts were noted within the first 5 to 10 min of exposure at all concentrations.

Conclusion: PHMB demonstrated rapid and potent antibacter ial activity against both standard bacterial strains and clinical isolates, even at low concentrations. Its effectiveness at low con centrations provides significant advantages in terms of reducing cytotoxicity and environmental impact. Further research is war ranted to optimise dosing regimens, evaluate the risk of resistance development, and assess the long-term safety of PHMB to fully realise its clinical potential.

References

  • Pringle J. Observations on the diseases of the army in Camp and Garrison: in three volumes. Google Books; 1764. Available at: https://books.google.com. tr/books?id=-C4SjB8WSQIC&printsec=frontcover&source=gbs_ge_summary_r& cad=0#v=onepage&q&f=false. google scholar
  • Lister J. Amputation, anaesthetics. In: A System of Surgery, Theoretical and Practical, in Treatises by Various Authors. Vol. 3. Archive.org; 1860. Available at: https://archive.org/stream/observationsondi00prin/observation sondi00prin_djvu.txt. google scholar
  • Lister J. An address on the present position of antiseptic surgery. Br Med J 1890;2(1546):377. google scholar
  • Eberlein T, Assadian O. Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination. Skin Pharmacol Physiol 2010;23(1):45-51. google scholar
  • Kamaruzzaman NF, Firdessa R, Good L. Bactericidal effects of polyhexamethylene biguanide against intracellular Staphylococcus aureus EMRSA-15 and USA 300. J Antimicrob Chemother 2016;71(5):1252-9. google scholar
  • Krebs FC, Miller SR, Ferguson ML, Labib M, Rando RF, Wigdahl B. Polybiguanides, particularly polyethylene hexamethylene biguanide, have activity against human immunodeficiency virus type 1. Biomed Pharmacother 2005;59(8):438-45. google scholar
  • Donlan RM. Biofilms and device-associated infections. Emerg Infect Dis 2001;7(2):277-81. google scholar
  • Zheng Y, Wang D, Ma LZ. Effect of polyhexamethylene biguanide in combination with undecylenamidopropyl betaine or PslG on biofilm clearance. Int J Mol Sci 2021;22(2):1-12. google scholar
  • Machuca J, Lopez-Rojas R, Fernandez-Cuenca F, Pascual Á. Comparative activity of a polyhexanide-betaine solution against biofilms produced by multidrugresistant bacteria belonging to high-risk clones. J Hosp Infect 2019;103:e92-e96. google scholar
  • Avci D, Otkun M. Evalution of antibacterial activities of some antiseptics and disinfectants. Turk Hij Den Biyol Derg 2017;74(3):211-20. google scholar
  • Mangoni ML, Papo N, Barra D, Simmaco M, Bozzi A, Di Giulio A, et al. Effects of the antimicrobial peptide temporin L on cell morphology, membrane permeability and viability of Escherichia coli. Biochem J 2004;380(Pt 3):859. google scholar
  • Mashat BH. Polyhexamethylene biguanide hydrochloride: Features and applications. Int J Environ Sci 2016;4(1):49-55. google scholar
  • Niro A, Pignatelli F, Fallico M, Sborgia A, Passidomo F, Gigliola S, et al. Polyhexamethylene biguanide hydrochloride (PHMB)-properties and application of an antiseptic agent. A narrative review. Eur J Ophthalmol 2022;11206721221124684. google scholar
  • Sripriya R, Jayaraj G. Biocompatibility and efficiency of polyhexamethylene biguanide-based antiseptic dressings in wound management. J Wound Care 2018;27(9):630-7. google scholar
  • Montemezzo M, Ferrari MD, Kerstner E, Santos VD, Victorazzi Lain V, Wollheim C, et al. PHMB-loaded PDMS and its antimicrobial properties for biomedical applications. J Biomater Appl 2021;36(2):252-63. google scholar
  • Cooper RA. Polyhexamethylene biguanide (PHMB): antibacterial activity and clinical applications. J Antimicrobial Chemotherapy 2004;53(4):549-51. google scholar
  • Moore M, Gray D. Evaluation of the antimicrobial efficacy of PHMB formulations at low concentrations. J Hospital Infect 2007;65(1):41-7. google scholar
  • Sutton JM, Olson ME. Polyhexamethylene biguanide (PHMB) as an antimicrobial agent in wound care: a review. Int J Antimicrobial Agents 2013;42(2):143-50. google scholar
  • Hardy K, Sunnucks K, Gil H, Shabir S, Trampari E, Hawkey P, et al. Increased Usage of Antiseptics Is Associated with Reduced Susceptibility in Clinical Isolates of Staphylococcus aureus. mBio 2018;9(3):e00894-18. google scholar
  • LaBreck PT, Bochi-Layec AC, Stanbro J, Dabbah-Krancher G, Simons MP, Merrell DS. Systematic Analysis of Efflux Pump-Mediated Antiseptic Resistance in Staphylococcus aureus Suggests a Need for Greater Antiseptic Stewardship. mSphere 2020;5(1):e00959-19. google scholar
  • Davis SC, Harding A, Gil J, Parajon F, Valdes J, Solis M, et al. Effectiveness of a polyhexanide irrigation solution on methicillin-resistant Staphylococcus aureus biofilms in a porcine wound model. Int Wound J 2017;14(6):937-44. google scholar
  • Alves PJ, Barreto RT, Barrois BM, Gryson LG, Meaume S, Monstrey SJ. Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm. Int Wound J 2021;18(2):342-58. google scholar
There are 22 citations in total.

Details

Primary Language English
Subjects Infectious Diseases, Clinical Microbiology
Journal Section Research Article
Authors

Didem Akal Taşcıoğlu 0000-0003-2172-2611

Gülay İmadoğlu Yetkin 0000-0002-6115-3583

Evren Kılınç 0000-0002-1697-6580

Burak Karacan 0000-0003-1166-3101

Publication Date October 28, 2025
Submission Date April 21, 2025
Acceptance Date September 19, 2025
Published in Issue Year 2025 Volume: 8 Issue: 3

Cite

MLA Taşcıoğlu, Didem Akal et al. “Investigation of the Antibacterial Activity of Polyhexamethylene Biguanide (PHMB) Against Multidrug-Resistant and Standard Bacterial Isolates”. Journal of Advanced Research in Health Sciences, vol. 8, no. 3, 2025, pp. 163-7, doi:10.26650/JARHS2025-1680666.