Impact of daily octenidine skin washing on antiseptic tolerance of coagulase-negative staphylococci in two neonatal intensive care units with different bathing practices

Background: Coagulase Negative Staphylococci (CoNS) are responsible for 80-90 % of catheter related sepsis in neonates which can cause life threatening and damaging effects. NICUs within the UK use various practices to decolonise neonates to prevent infection ranging from regular full body bathing to localised skin decontamination before insertion of indwelling devices. There is a disparity in bathing practices for infants admitted onto neonatal units, with some choosing to regularly bathe infants and others not, and some routinely washing with skin antiseptics, and others not. Aim: To compare the abundance of CoNS within two UK NICUs with different approaches to skin bathing and to test their tolerances to antiseptics. Methods: A collection of CoNS from two UK based NICUs with differing bathing routines for neonates were collated and tested for susceptibility to the antiseptics in use, octenidine and chlorhexidine. Findings: Regular bathing of neonates in octenidine did not decrease the abundance of organisms on neonatal skin. Isolates from the unit where octenidine was in frequent use did not show any increased antiseptic tolerance. Isolates from the unit where regular bathing was not routine practice were less susceptible to both antiseptics. Conclusion: Frequent whole-body skin washing with octenidine does not appear to result in a lasting reduction in numbers of organisms found on the skin but also does not appear to select for antiseptic tolerant CoNS.