Background: The skin bacterium Propionibacterium acnes has been reported to be responsible for surgical site infections (SSIs). Skin disinfection before surgery therefore is of the utmost importance in the prevention of SSIs caused by skin bacteria.
Methods: We assessed the susceptibility of clinical isolates of two skin bacteria, P. acnes and Staphylococcus epidermidis, to disinfectants.
Results: The range of chlorhexidine digluconate (CHG) minimum inhibitory concentrations (MICs) for P. acnes isolates was 0.25-1 mcg/mL. Furthermore, the minimum bactericidal concentrations (MBCs) for a range of disinfectants were determined to evaluate their rapid bactericidal activity. The MBC range of CHG against the P. acnes isolates was 4,096->32,768 mcg/mL (MBC80 16,384 mcg/mL) after one minute of exposure and 1,024-32,768 mcg/mL (MBC80 8,192 mcg/mL) after five minutes, indicating that some strains required a CHG MBC higher than the commercial concentration of 2% (20,000 mcg/mL). In contrast, the MBCs of glutaraldehyde, sodium hypochlorite, povidone-iodine, ethanol, benzalkonium chloride, and olanexidine gluconate were all sufficiently lower than their commercial concentrations. In S. epidermidis, the MBC range of CHG was 128-1,024 mcg/mL at one minute of exposure and 4-8 mcg/mL at five minutes.
Conclusions: Different skin bacteria have different susceptibilities to disinfectants. To prevent SSIs, the selected disinfectant agent and the disinfection time should have bactericidal activity toward all the bacteria that pose a risk of infection.
Keywords: Propionibacterium acnes; chlorhexidine digluconate; minimum bactericidal concentration; staphylococcus epidermidis; surgical site infection.