dgkh000393 10.3205/dgkh000393 urn:nbn:de:0183-dgkh0003937 Letter to the Editor Papke Papke Roald R

Sana Klinikum Lichtenberg, Fanningerstraße 32, 10365 Berlin, GermanySana Klinikum Lichtenberg, Berlin, Germany

author German Medical Science GMS Publishing House

Düsseldorf

610 20210624 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). 2196-5226 16 GMS Hygiene and Infection Control GMS Hyg Infect Control 22 Letter to the editorIn the publication by Exner et al. , it states “Alcohol-based handrubs, containing ethanol or 1-propanol or 2-propanol as their main active substances are the gold standard for handrubs in Europe. For example, the German KRINKO recommends the use of alcohol-based products without any other additives such as chlorhexidine (CHG) or mecetronium ethylsulfate. Concern as to resistance development of certain bacterial strains to chlorhexidine is increasing, e.g., CHG resistance may be detected in multi-resistant isolates such as extremely drug-resistant Klebsiella pneumoniae , , , , .”In the cited KRINKO recommendation sustained effective additives in alcohol-based hand disinfectants are not recommended, and the following antiseptic agents are given exemplary: chlorhexidine digluconate, octenidine hydrochloride, polihexanide, triclosan, quaternary ammonium compounds, ampholytes and phenol derivatives. In this context, allow me to ask whether mecetronium ethylilsulfate can be used as an active ingredient. NotesCompeting interestsThe author declares that he has no competing interests. Exner M Bhattacharya S Gebel J Goroncy-Bermes P Hartemann P Heeg P Ilschner C Kramer A Ling ML Merkens W Oltmanns P Pitten F Rotter M Schmithausen RM Sonntag HG Steinhauer K Trautmann M Chemical disinfection in healthcare settings: critical aspects for the development of global strategies 2020 GMS Hyg Infect Control Doc36 Exner M, Bhattacharya S, Gebel J, Goroncy-Bermes P, Hartemann P, Heeg P, Ilschner C, Kramer A, Ling ML, Merkens W, Oltmanns P, Pitten F, Rotter M, Schmithausen RM, Sonntag HG, Steinhauer K, Trautmann M. Chemical disinfection in healthcare settings: critical aspects for the development of global strategies. GMS Hyg Infect Control. 2020 Dec 23;15:Doc36. DOI: 10.3205/dgkh000371 https://doi.org/10.3205/dgkh000371 Kampf G Acquired resistance to chlorhexidine – is it time to establish an ‘antiseptic stewardship’ initiative? J Hosp Infect 2016 Kampf G. Acquired resistance to chlorhexidine – is it time to establish an ‘antiseptic stewardship’ initiative? J Hosp Infect. 2016 Nov;94(3):213-27. DOI: 10.1016/j.jhin.2016.08.018 https://doi.org/10.1016/j.jhin.2016.08.018 Hardy K Sunnucks K Gil H Shabir S Trampari E Hawkey P Webber M Increased Usage of Antiseptics Is Associated with Reduced Susceptibility in Clinical Isolates of Staphylococcus aureus 2018 mBio e00894-18 Hardy K, Sunnucks K, Gil H, Shabir S, Trampari E, Hawkey P, Webber M. Increased Usage of Antiseptics Is Associated with Reduced Susceptibility in Clinical Isolates of Staphylococcus aureus. mBio. 2018 May;9(3):e00894-18. DOI: 10.1128/mBio.00894-18 https://doi.org/10.1128/mBio.00894-18 Kommission für Krankenhaushygiene und Infektionsprävention am Robert Koch-Institut Empfehlungen zur Händehygiene 2016 Bundesgesundheitsbl 1189-220 Kommission für Krankenhaushygiene und Infektionsprävention am Robert Koch-Institut. Empfehlungen zur Händehygiene. Bundesgesundheitsbl. 2016;59:1189-220. Saleem HG Seers CA Sabri AN Reynolds EC Dental plaque bacteria with reduced susceptibility to chlorhexidine are multidrug resistant 2016 BMC Microbiol 214 Saleem HG, Seers CA, Sabri AN, Reynolds EC. Dental plaque bacteria with reduced susceptibility to chlorhexidine are multidrug resistant. BMC Microbiol. 2016 Sep;16:214. DOI: 10.1186/s12866-016-0833-1 https://doi.org/10.1186/s12866-016-0833-1 Choudhury MA Sidjabat HE Rathnayake IU Gavin N Chan RJ Marsh N Banu S Huygens F Paterson DL Rickard CM McMillan DJ Culture-independent detection of chlorhexidine resistance genes qacA/B and smr in bacterial DNA recovered from body sites treated with chlorhexidine-containing dressings 2017 J Med Microbiol 447-53 Choudhury MA, Sidjabat HE, Rathnayake IU, Gavin N, Chan RJ, Marsh N, Banu S, Huygens F, Paterson DL, Rickard CM, McMillan DJ. Culture-independent detection of chlorhexidine resistance genes qacA/B and smr in bacterial DNA recovered from body sites treated with chlorhexidine-containing dressings. J Med Microbiol. 2017 Apr;66(4):447-53. DOI: 10.1099/jmm.0.000463 https://doi.org/10.1099/jmm.0.000463 0 0 0 0