Tolerance to disinfectants (chlorhexidine and isopropanol) and its association with antibiotic resistance in clinically-related Klebsiella pneumoniae isolates

Jasmine Morante, Antonio M. Quispe, Barbara Ymaña, Jeel Moya-Salazar, Néstor Luque, Gabriela Soza, María Ramos Chirinos, Maria J. Pons

Research output: Contribution to journalOriginal Articlepeer-review

7 Scopus citations


Disinfectants play an essential role in controlling the dissemination of bacteria in health care settings, but it may also contribute to the selection of antibiotic resistance bacteria. This study looked at Klebsiella pneumoniae isolates collected from three hospitals in Lima, Peru, in order to evaluate: their susceptibility to chlorhexidine [CHG] and isopropanol [ISP]), and their association with antimicrobial susceptibility. We analyzed 59 K. pneumoniae isolates and assessed their CHG and ISP susceptibility by minimum inhibitory concentrations (MICs). Additionally, we performed a regression analysis to assess the association between disinfectant tolerance and antibiotic resistance (measured by the disc diffusion method), colistin resistance (by microdilution), carbapenemases presence (by polymerase chain reaction [PCR]), and clonal relationships (by pulsed-field gel electrophoresis [PFGE]). Eleven K. pneumoniae strains were isolated from fomites, and 48 strains from clinical samples. The MIC range of these isolates was 8–128 µg/ml for CHG and 16–256 mg/ml for ISP. We found that resistance to trimethoprim/sulfamethoxazole (TMP/SMX) was the main factor associated with CHG log2 MIC (ß = 0.65; 95%CI: 0.03, 1.27; R2 = 0.07). In the case of ISP, the log2(MIC) was associated with the institution of origin, showing lower ISP log2(MIC) in fomites compared to clinical samples(ß = −0.77; 95%CI: −1.54, −0.01; R2 = 0.08). Resistance to CHG and ISP among K. pneumoniae isolates found in Peruvian hospitals seems to be elevated and highly variable. Further studies are needed to confirm our results and implement actionable interventions if necessary.

Original languageAmerican English
Pages (from-to)53-60
Number of pages8
JournalPathogens and Global Health
Issue number1
StateIndexed - 2021

Bibliographical note

Funding Information:
This work was supported by the Universidad Cientifica del Sur, ‘Semilla 2019-01 grant’. We thank the members of the Microbiology Laboratory team of the three hospitals involved for their kind collaboration. The authors thank Donna Pringle for editorial assistance.

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.


  • Disinfectants
  • alcohol-based disinfectants
  • antibiotic resistance
  • chlorhexidine
  • cross-resistance
  • kKebsiella pneumoniae


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