Skip to main content
SpringerLink
Log in

Chlorhexidine: Antibacterial action and bacterial resistance

Chlorhexidin: Antibakterielle Wirkung und bakterielle Resistenz

  • Comment
  • Published:
Infection Aims and scope Submit manuscript

Summary

Chlorhexidine is a clinically important antiseptic, disinfectant and preservative. It is a potent membrane-active agent against bacteria and inhibits outgrowth, but not germination, of bacterial spores, although it is not sporicidal. It shows high activity against wild-type and outer membrane mutants ofEscherichia coli but some gram-negative bacteria are resistant to chlorhexidine by mechanisms not yet fully understood, although they appear to involve the outer, rather than the inner, membrane.

Zusammenfassung

Chlorhexidin hat als Antiseptikum, Desinfiziens und Konservierungsmittel große klinische Bedeutung. Chlorhexidin ist als membranaktive Substanz hochwirksam gegen Bakterien und hemmt die Vermehrung, aber nicht das Aussprossen von Bakteriensporen, obwohl es keine sporizide Substanz ist. Gegen den Wildtyp und andere Membranvarianten vonEscherichia coli ist Chlorhexidin hochwirksam; einige gramnegative Bakterien sind jedoch gegen Chlorhexidin resistent; die dafür verantwortlichen Mechanismen sind noch nicht voll aufgeklärt, doch scheint es, daß eher die äußere als die innere Membran betroffen ist.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literature

  1. Hugo, W. B., Russell, A. D. Types of antimicrobial agents. In:Russell, A. D., Hugo, W. B., Ayliffe, G. A. J. (eds.): Principles and practice of disinfection, preservation and sterilisation. Blackwell Scientific Publications, Oxford 1982, pp. 8–106.

    Google Scholar 

  2. Wallhauser, K. H. Antimicrobial preservatives used by the cosmetic industry. In:Kabara, J. J. (ed.): Cosmetic and drug preservation: principles and practice. Marcel Dekker, New York 1984, pp. 605–745.

    Google Scholar 

  3. Hugo, W. B. Disinfection mechanisms. In:Russell, A. D., Hugo, W. B., Ayliffe, G. A. J. (eds.): Principles and practice of disinfection, preservation and sterilisation. Blackwell Scientific Publications, Oxford, 1982, pp. 158–185.

    Google Scholar 

  4. Hugo, W. B. Membrane-active antimicrobial compounds — a reappraisal of their mode of action in the light of the chemiosmotic theory. Int. J. Pharm. 1 (1978) 127–131.

    Google Scholar 

  5. Walters, T. H., Furr, J. R., Russell, A. D. Antifungal action of chlorhexidine. Microbios. 38 (1983) 195–204.

    Google Scholar 

  6. Shafer, L. A., Russell, A. D., Furr, J. R.: Aspects of the action of chlorhexidine on bacterial spores. Int. J. Pharm. (1986) (in print).

  7. Nikaido, H., Vaara, M. Molecular basis of bacterial outer membrane permeability. Microbiol. Rev. 49 (1985) 1–32.

    Google Scholar 

  8. Hancock, R. E. W. Alterations in outer membrane permeability. Ann. Rev. Microbiol. 38 (1984) 237–264.

    Google Scholar 

  9. Stickler, D. J., Thomas, B. Intrinsic resistance to non-antibiotic antibacterial agents. In:Russell, A. D., Hugo, W. B., Ayliffe, G. A. J. (eds.): Principles and practice of disinfection, preservation and sterilisation. Blackwell Scientific Publications, Oxford 1982, pp. 186–198.

    Google Scholar 

  10. Stickler, D. J., Thomas, B., Clayton, C. L., Chawla, J. C.: Studies on the genetic basis of chlorhexidine resistance. Br. J. Clin. Pract. Symposium No. 25 (1983) 23–28.

  11. El-Falaha, B. M. A., Russell, A. D., Furr, J. R. Sensitivities of wild type and envelope-defective strains ofEscherichia coli andPseudomonas aeruginosa to antibacterial agents. Microbios. 38 (1983) 99–105.

    Google Scholar 

  12. El-Falaha, B. M. A., Russell, A. D., Furr, J. R., Rogers, D. T. Activity of benzalkonium chloride and chlorhexidine diacetate against wild-type and envelope mutants ofEscherichia coli andPseudomonas aeruginosa. Int. J. Pharm. 25 (1985) 329–337.

    Google Scholar 

  13. Russell, A. D., Furr, J. R. Susceptibility of porin- and lipopolysaccharide-deficient strains ofEscherichia coli to some antiseptics and disinfectants. J. Hosp. Infect. 8 (1986) 47–56.

    Google Scholar 

  14. Russell, A. D., Furr, J. R.: Comparative sensitivity of smooth, rough and deep rough strains ofEscherichia coli to chlorhexidine, quaternary ammonium compounds and dibromopropamidine isothionate. Int. J. Pharm. (1987) (in print).

  15. Lieve, L. The barrier function of the gram-negative cell envelope. Ann. N.Y. Acad. Sci. 235 (1974) 109–129.

    Google Scholar 

  16. Russell, A. D., Furr, J. R.: The effect of antiseptics, disinfectants and preservatives on smooth, rough and deep rough strains ofSalmonella typhimurium. Int. J. Pharm. (1986) (in print).

  17. El-Falaha, B. M. A., Rogers, D. T., Furr, J. R., Russell, A. D. Surface changes inPseudomonas aeruginosa exposed to chlorhexidine diacetate and benzalkonium chloride. Int. J. Pharm. 23 (1985) 239–243.

    Google Scholar 

  18. El-Falaha, B. M. A., Rogers, D. T., Russell, A. D., Furr, J. R. Effect of some antibacterial agents on the hydrophobicity of wild-type and envelope mutant ofEscherichia coli. Curr. Microbiol. 12 (1985) 187–190.

    Google Scholar 

  19. El-Moug, T., Rogers, D. T., Furr, J. R., El-Falaha, B. M. A., Russell, A. D. Antiseptic-induced changes in the cell surface of a chlorhexidine-sensitive and a chlorhexidine-resistant strain ofProvidencia stuartii. J. Antimicrob. Chemother. 16 (1985) 685–689.

    Google Scholar 

  20. Fisher, R. G., Quintana, R. P., Boulware, M. A. Surface-chemical studies on chlorhexidine and related compounds. I. Effects at air-water, n-hexane-water, and hydroxyapatite-water interfaces. J. Dent. Res. 54 (1975) 20–24.

    Google Scholar 

  21. Fisher, R. G., Quintana, R. P. Surface-chemical studies on chlorhexidine and related compounds. II. Interaction with monomolecular-film systems. J. Dent. Res. 54 (1975) 25–31.

    Google Scholar 

  22. Ismaeel, N., Furr, J. R., Russell, A. D.: Reversal of the surface effects of chlorhexidine diacetate on cells ofProvidencia stuartii. J. Appl. Bact. (1986) (in print).

  23. Klemperer, R. M. M., Ismail, N. T. A. J., Brown, M. R. W.: Effect of R-plasmid RPl and nutrient depletion on the resistance ofEscherichia coli to cetrimide, chlorhexidine and phenol. J. Appl. Bacteriol. (1980) 349–357.

  24. Broxton, P., Woodcock, P. M., Heatley, F., Gilbert, P. Interaction of some polyhexamethylene biguanides and membrane phospholipids inEscherichia coli. J. Appl. Bacteriol. 57 (1984) 115–124.

    Google Scholar 

  25. Thomas, B., Stickler, D. J. Chlorhexidine resistance and the lipids ofProvidencia stuartii. Microbios. 24 (1979) 141–150.

    Google Scholar 

  26. El-Moug, T., Furr, J. R., Russell, A. D. Effect of chlorhexidine on a chlorhexidine-sensitive and a chlorhexidine-resistant strain ofProvidencia stuartii. Lett. Appl. Microbiol. 1 (1985) 37–40.

    Google Scholar 

  27. Ismaeel, N., Furr, J. R., Russell, A. D. Resistance ofProvidencia stuartii to chlorhexidine: A consideration of the role of the inner membrane. J. Appl. Bacteriol. 60 (1986) 361–367.

    Google Scholar 

  28. Lannigan, R., Bryan, L. E. Decreased susceptibility ofSerratia marcescens to chlorhexidine related to the inner membrane. J. Antimicrob. Chemother. 15 (1985) 559–565.

    Google Scholar 

  29. Norris, M. J., Rogers, D. T., Russell, A. D. Cell envelope composition and sensitivity ofProteus mirabilis, Pseudomonas aeruginosa andSerratia marcescens to polymyxin and other antibacterial agents. Lett. Appl. Microbiol. 1 (1985) 3–6.

    Google Scholar 

  30. Sidorczyk, K., Zahringer, U., Rietschel, E. T. Chemical structure of the lipid A component of the lipopolysaccharide from aProteus mirabilis Re mutant. Eur. J. Biochem. 137 (1983) 15–22.

    Google Scholar 

  31. Ahonkhai, I., Russell, A. D. Response of RP1+ and RP1− strains ofEscherichia coli to antibacterial agents and transfer of resistance toPseudomonas aeruginosa. Curr. Microbiol. 3 (1979) 89–94.

    Google Scholar 

  32. Ahonkhai, I., Pugh, W. J., Russell, A. D. Sensitivity to antimicrobial agents of some mercury-sensitive and mercury-resistant strains of gram-negative bacteria. Curr. Microbiol. 11 (1984) 183–185.

    Google Scholar 

  33. Russell, A. D. The role of plasmids in bacterial resistance to antiseptics, disinfectants and preservatives. J. Hosp. Infect. 6 (1985) 9–19.

    Google Scholar 

  34. Michel-Briand, Y., Laporte, J. M., Bassignot, A., Plesiat, P.: A note on antibiotic resistance plasmids and bactericidal effect of chlorhexidine onEnterobacteriaceae. J. Appl. Bacteriol. (1986) (in print).

  35. Russell, A. D. The destruction of bacterial spores. Academic Press, London 1982.

    Google Scholar 

  36. Townsend, D. E., Ashdown, N., Greed, L. C., Grubb, W. B. Transposition of gentamicin resistance to staphylococcal plasmids encoding resistance to cationic agents. J. Antimicrob. Chemother. 14 (1984) 115–124.

    Google Scholar 

  37. Townsend, D. E., Ashdown, N., Bradley, J. M., Pearman, J. W., Grubb, W. B. “Australian” methicillin-resistantStaphylococcus aureus in a London hospital. Med. J. Aust. II (1984) 339–340.

    Google Scholar 

  38. Tennent, J. M., Lyon, B. R., Gillespie, M. T., May, J. W., Skurray, R. A. Cloning and expression ofStaphylococcus aureus plasmid-mediated quaternary ammonium resistance inEscherichia coli. Antimicrob. Agents Chemother. 27 (1985) 79–83.

    Google Scholar 

  39. Brumfitt, W., Dixson, S., Hamilton-Miller, J. M. T. Resistance to antiseptics in methicillin and gentamicin resistantStaphylococcus aureus. Lancet I (1985) 1442–1443.

    Google Scholar 

  40. Lowbury, E. J. L. Special problems in hospital antisepsis. In:Russell, A. D., Hugo, W. B., Ayliffe, G. A. J. (eds.): Principles and practice of disinfection, preservation and sterilisation. Blackwell Scientific Publications, Oxford 1982, pp. 262–284.

    Google Scholar 

  41. Platt, J., Bucknell, R. A. An experimental evaluation of antiseptic wound irrigation. J. Hosp. Infect. 5 (1984) 181–188.

    Google Scholar 

  42. Bygdeman, S., Hambraeus, A., Henningsson, A., Nyström, B., Skoglund, C., Tunell, R. Influence of ethanol with and without chlorhexidine on the bacterial colonization of the umbilicus of newborn infants. Infect. Control 6 (1984) 275–278.

    Google Scholar 

  43. Loe, H., Schiott, C. R. The effect of mouth rinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J. Periodont. Res. 5 (1970) 79–83.

    Google Scholar 

  44. Ainamo, J. Control of plaque by chemical agents. J. Clin. Periodont. 4 (1977) 23.

    Google Scholar 

  45. Russell, A. D., Hammond, S. A., Morgan, J. R. Bacterial resistance to antiseptics and disinfectants. J. Hosp. Infect. 7 (1986) 213–225.

    Google Scholar 

  46. Hammond, S. A., Morgan, J. R., Russell, A. D.: Comparative susceptibility of hospital isolates of gram-negative bacteria to antiseptics and disinfectants. J. Hosp. Infect. (1986) (in print).

  47. Pitt, T. L., Gaston, M. A., Hoffman, P. N. In vitro sensitivity of hospital isolates in various bacterial genera to chlorhexidine. J. Hosp. Infect. 4 (1983) 173–176.

    Google Scholar 

  48. Walker, E. M., Lowes, J. A. An investigation ofin vitro methods for the detection of chlorhexidine resistance. J. Hosp. Infect. 6 (1985) 389–397.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pharmaceutical Microbiology Research Laboratory, Welsh School of Pharmacy, University of Wales Institute of Science and Technology, P.O. Box 13, CF1 3XF, Cardiff, Wales

    A. D. Russell D.Sc., Ph.D. & F. R. C. Path

Authors
  1. A. D. Russell D.Sc., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. R. C. Path
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Russell, A.D., Path, F.R.C. Chlorhexidine: Antibacterial action and bacterial resistance. Infection 14, 212–215 (1986). https://doi.org/10.1007/BF01644264

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01644264

Keywords

Search

Navigation