Antimicrobial efficacy of chlorhexidine digluconate alone and in combination with eucalyptus oil, tea tree oil and thymol against planktonic and biofilm cultures of Staphylococcus epidermidis

Objectives Effective skin antisepsis and disinfection of medical devices are key factors in preventing many healthcare-acquired infections associated with skin microorganisms, particularly Staphylococcus epidermidis. The aim of this study was to investigate the antimicrobial efficacy of chlorhexidin...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2008-11, Vol.62 (5), p.1031-1036
Main Authors: Karpanen, T. J., Worthington, T., Hendry, E. R., Conway, B. R., Lambert, P. A.
Format: Article
Language:English
Subjects:
Anti-Infective Agents - pharmacology
Antibiotics. Antiinfectious agents. Antiparasitic agents
antimicrobial activity
Bacteria
Biofilms - drug effects
Biological and medical sciences
chlorhexidine
Chlorhexidine - analogs & derivatives
Chlorhexidine - pharmacology
Disinfection & disinfectants
Drug Synergism
essential oils
Eucalyptus
Eucalyptus - chemistry
Herbal medicine
Medical sciences
Melaleuca
Melaleuca - chemistry
Microbial Sensitivity Tests
Microbial Viability - drug effects
Pharmacology
Pharmacology. Drug treatments
Plant Oils - pharmacology
Skin
skin antisepsis
Staphylococcus epidermidis
Staphylococcus epidermidis - drug effects
synergism
Thymol - pharmacology
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Summary:Objectives Effective skin antisepsis and disinfection of medical devices are key factors in preventing many healthcare-acquired infections associated with skin microorganisms, particularly Staphylococcus epidermidis. The aim of this study was to investigate the antimicrobial efficacy of chlorhexidine digluconate (CHG), a widely used antiseptic in clinical practice, alone and in combination with tea tree oil (TTO), eucalyptus oil (EO) and thymol against planktonic and biofilm cultures of S. epidermidis. Methods Antimicrobial susceptibility assays against S. epidermidis in a suspension and in a biofilm mode of growth were performed with broth microdilution and ATP bioluminescence methods, respectively. Synergy of antimicrobial agents was evaluated with the chequerboard method. Results CHG exhibited antimicrobial activity against S. epidermidis in both suspension and biofilm (MIC 2–8 mg/L). Of the essential oils thymol exhibited the greatest antimicrobial efficacy (0.5–4 g/L) against S. epidermidis in suspension and biofilm followed by TTO (2–16 g/L) and EO (4–64 g/L). MICs of CHG and EO were reduced against S. epidermidis biofilm when in combination (MIC of 8 reduced to 0.25–1 mg/L and MIC of 32–64 reduced to 4 g/L for CHG and EO, respectively). Furthermore, the combination of EO with CHG demonstrated synergistic activity against S. epidermidis biofilm with a fractional inhibitory concentration index of
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkn325