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27 ANTIBIOTIC RESISTANCE & STEWARDSHIP Study Links Antibiotic Resistance With Chlorhexidine Exposure By Heather Punke W hen Klebsiella pneumoniae bacteria are exposed to disin- fectants containing chlorhexidine, the bacteria can be- come resistant to colistin, a last-resort antibiotic, accord- ing to a study published in Antimicrobial Agents and Chemotherapy, a journal of the American Society for Microbiology. e study is the first ever to link chlorhexidine exposure with colistin resistance. Researchers tested strains of K. pneumoniae typically found in health- care settings and exposed them to increasing concentrations of chlor- hexidine. While some strains died from the exposure, others survived and some gained resistance to colistin. ey also discovered gene mutations in some of the surviving strains that conferred resistance to both colistin and chlorhexidine. "Chlorhexidine is a critical part of current infection control practices, and the development of increased resistance to this compound has po- tential implications for our ability to prevent infections during routine and emergency surgery, and during admission to hospitals," said J. Mark Sutton, PhD, the study's co-author. "is might mean that we need to rethink how and where some types of critical disinfectants or antiseptics are used in the clinic," he said. n WWI Antiseptic Could Prove Useful in Superbug Fight By Brian Zimmerman A century-old topical antiseptic can effectively pro- tect against the common cold and shows potential for use in the battle against antibiotic resistance, according to a recent study published in the journal of Nucleic Acids Research. Acriflavine is made from coal tar and was used in World War I to treat wounds. The antiseptic was also used up until World War II to treat gonorrhea, urinary infections and tropical disease, but has been out of use for more than 50 years. For the study, researchers discovered pretreating human lung cells with the antiseptic triggered an antiviral immune response, which protected the cells from rhinovirus infec- tion. Because the antiseptic both innately attacks bacte- ria and activates the immune system, researchers think it could prove effective in both the fight against antibiotic resistance and viral disease pandemics. "Acriflavine was used in the first half of the 20th century as a topical antibacterial, before being supplanted by peni- cillin," said Genevieve Pepin, PhD, first author of the paper and scientist with the Hudson Institute of Medical Research in Australia. "Our study indicates that Acriflavine stimulates the host immune system, rather than simply killing bacte- ria, suggesting it wouldn't be as likely to drive mutations in bacteria — showing a safeguard against resistance and a potential alternative to current antibacterial drugs." n Syphilis Resurgence Linked to Antibiotic-Resistant, Pandemic Strain By Brian Zimmerman R ates of syphilis infection, once hampered by the discovery of penicillin, have been rising in recent years. Researchers recently linked the increase in modern syphilis cases to a pandemic, antibiotic-re- sistant cluster that emerged after 1950, according to a study published in the journal Nature. For the study, researchers collected 70 clinical and lab- oratory samples of syphilis, yaws and bejel infections from 13 countries. Bejel and yaws are in the same bac- terial family as syphilis and have similar clinical man- ifestations. By using genomic data, researchers were able to reconstruct a phylogenetic tree showing a clear separation between the genetic lineage of modern syphilis infections and its bacterial counterparts bejel and yaws. While modern syphilis infections have displayed resis- tance to azithromycin, a common treatment for sexually transmitted diseases, it has not yet displayed resistance to penicillin. The researchers suggested their findings call for extensive studies on the contemporary, pandem- ic syphilis strain. n Acriflavine was used to treat wounds, gonorrhea, urinary tract infections and tropical disease in World War I and II, but then fell out of use.