Abstract
The concentration of chlorhexidine digluconate required to kill Gram-negative bacteria which cause urinary tract infection associated with urethral catheterisation also damages the bladder mucosa. Increased bactericidal activity was obtained by the addition of a chelating agent (EDTA) and a buffer (Tris) enabling a low concentration of chlorhexidine (0.01 per cent) to be effective against Escherichia coli NCTC 86, Pseudomonas aeruginosa NCTC 7650 Proteus mirabilis NCTC 8309 and Streptococcus faecalis NCTC 8213. The type of fluid in which the bacteria were suspended affected the time required to achieve 99.9 per cent killing. The 0.01 per cent chlorhexidine solution with added EDTA and Tris did not cause severe erosive damage to the bladder mucosa of rats. The potential of this solution for use as a skin antiseptic prior to catheterisation and as a bladder instillation after catheterisation is discussed.
Similar content being viewed by others
Article PDF
References
Beeuweeks, H & de Vries, H R (1956). Chlorhexidine in Urology. Lancet, 2, 913–914.
Brown, M R W & Richards, R M W (1965). Effect of ethylene diamine tetraacetate on the resistance of Pseudomonas aeruginosa to antibacterial agents. Nature, 207, 1391–1393.
Caplin, H & Chapman, D C (1976). A comparison of three commercially available antiseptics against opportunist Gram-negative pathogens. Microbios., 16, 133–137.
Cutinelli, C & Galdiero, F (1967). Ion binding properties of the cell wall of Staphylococcus. J. Bact., 93, 2022.
Gillespir, W A, Lennon, G G, Linton, K B & Slade, N (1962). Prevention of catheter infection of urine in female patients. Brit. Med. J., 2, 13–16.
Goldschmidt, M C, Kuhn, C R, Perry, K & Johnson, D E (1972). EDTA and lysozyme lavage in the treatment of Pseudomonas and coliform bladder infections. J. Urol. (Baltimore) 107, 969–972.
Goldschmidt, M C & Wyss, O (1967). The Role of Tris in EDTA toxicity and lysozyme lysis. J. Gen. Microbiol., 47, 421–430.
Greenwood, D & O'Grady, F (1975). Response of ampicillin resistant escherichia coli to cephalorins in an in vitro model simulating conditions of bacterial growth in the urinary bladder. Brit. J. exp. Path., 56, 167–171.
Harper, W E S & Matz, L T (1976). Further studies on effects of irrigation solutions on rat bladders. Brit. J. Urol., 47, 463–467.
Lindan, R (1972). Sources of Urinary Sepsis in Urethral Catheterization. Paper read at Symposium International Sobre Infection del Tracto Urinario. Jimenex Diaz Foundation, Madrid, Spain, November.
Macfadyen, I R & Simmons, S C (1968). Urinary infection after colporrhaphy: Its incidence causation and prevention. J. Obstet. Gynaec. Brit. Cwlth, 75, 871–875.
Paterson, M L, Barr, W & MacDonald, S (1960). Urinary infection after colporrhaphy: Its incidence causation and prevention. J. Obstet. Gynaec. Brit. Cwlth., 76, 394–401.
Pearman, J W (1971). Prevention of urinary tract infection. Following spinal cord injury. Paraplegia, 9, 95–104.
Pearman, J W (1977). Reducing the Risk of Bacteriuria from Indwelling Catheters. (Published in Abstracts of Proceedings) read at Australian Society for Microbiology Annual Scientific Meeting, Melbourne. 17-20 May.
Stickler, D J (1974). Chlorhexidine resistance in Proteus mirabilis. J. of Clin. Path., 27, 284–287.
Voss, J G (1967). Effects of organic cations on the Gram-negative cell wall and their bactericidal activity with Ethylenediaminetetra-acetate and surface active agents. J. Gen. Microbiol., 48, 391–400.
Author information
Authors and Affiliations
Additional information
Read at the Annual Scientific Meeting of the International Medical Society of Paraplegia, Athens, Greece. October 1982.
Rights and permissions
About this article
Cite this article
Harper, W. Simple additives to increase the activity of chlorhexidine digluconate against urinary pathogens. Spinal Cord 21, 86–93 (1983). https://doi.org/10.1038/sc.1983.12
Issue Date:
DOI: https://doi.org/10.1038/sc.1983.12