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Cieplik, Fabian ; Jakubovics, Nicholas S. ; Buchalla, Wolfgang ; Maisch, Tim ; Hellwig, Elmar ; Al-Ahmad, Ali

Resistance Toward Chlorhexidine in Oral Bacteria – Is There Cause for Concern?

Cieplik, Fabian, Jakubovics, Nicholas S., Buchalla, Wolfgang, Maisch, Tim, Hellwig, Elmar und Al-Ahmad, Ali (2019) Resistance Toward Chlorhexidine in Oral Bacteria – Is There Cause for Concern? Frontiers in Microbiology 10 (587), S. 1-11.

Veröffentlichungsdatum dieses Volltextes: 30 Apr 2019 09:04
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.40135


Zusammenfassung

The threat of antibiotic resistance has attracted strong interest during the last two decades, thus stimulating stewardship programs and research on alternative antimicrobial therapies. Conversely, much less attention has been given to the directly related problem of resistance toward antiseptics and biocides. While bacterial resistances toward triclosan or quaternary ammonium compounds have been ...

The threat of antibiotic resistance has attracted strong interest during the last two decades, thus stimulating stewardship programs and research on alternative antimicrobial therapies. Conversely, much less attention has been given to the directly related problem of resistance toward antiseptics and biocides. While bacterial resistances toward triclosan or quaternary ammonium compounds have been considered in this context, the bis-biguanide chlorhexidine (CHX) has been put into focus only very recently when its use was associated with emergence of stable resistance to the last-resort antibiotic colistin. The antimicrobial effect of CHX is based on damaging the bacterial cytoplasmic membrane and subsequent leakage of cytoplasmic material. Consequently, mechanisms conferring resistance toward CHX include multidrug efflux pumps and cell membrane changes. For instance, in staphylococci it has been shown that plasmid-borne qac (“quaternary ammonium compound”) genes encode Qac efflux proteins that recognize cationic antiseptics as substrates. In Pseudomonas stutzeri, changes in the outer membrane protein and lipopolysaccharide profiles have been implicated in CHX resistance. However, little is known about the risk of resistance toward CHX in oral bacteria and potential mechanisms conferring this resistance or even cross-resistances toward antibiotics. Interestingly, there is also little awareness about the risk of CHX resistance in the dental community even though CHX has been widely used in dental practice as the gold-standard antiseptic for more than 40 years and is also included in a wide range of oral care consumer products. This review provides an overview of general resistance mechanisms toward CHX and the evidence for CHX resistance in oral bacteria. Furthermore, this work aims to raise awareness among the dental community about the risk of resistance toward CHX and accompanying cross-resistance to antibiotics. We propose new research directions related to the effects of CHX on bacteria in oral biofilms.



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftFrontiers in Microbiology
Verlag:Frontiers
Band:10
Nummer des Zeitschriftenheftes oder des Kapitels:587
Seitenbereich:S. 1-11
Datum22 März 2019
InstitutionenMedizin > Lehrstuhl für Zahnärztliche Prothetik
Identifikationsnummer
WertTyp
10.3389/fmicb.2019.00587DOI
Stichwörter / Keywordsantiseptic, chlorhexidine, CHX, resistance, adaptation, tolerance, persistence, efflux pump
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-401359
Dokumenten-ID40135

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