Antimicrobial effect of alcoholic chlorhexidine on groin microflora in children

Abstract

Background: Organisms found in the groin region have been implicated in surgical site infections following groin surgery and procedures in children. This study documented the groin microflora and the effectiveness of alcoholic chlorhexidine in disinfecting the groin region before surgery in children.
Method: The prospective longitudinal study included children younger than 15 years old, who were scheduled for elective clean groin surgeries. At the operating theatre, aseptically obtained swabs of the groin region were taken at three different times: before application of antisepsis, after skin preparation and after completion of wound closure. The swabs were subjected to microbiology analysis, including identification of organism and quantitative bacterial colony count. The patients were followed up for thirty days post-operation, monitoring for the development of surgical site infection (SSI)
Results: A total of 113 children were recruited. The baseline swab revealed a positive culture in 93.3% of the patients, and Staphylococcus species were the only flora cultured in the groin in this study, with Staphylococcus epidermidis accounting for 65.5%. The alcoholic chlorhexidine antiseptic demonstrated good antimicrobial activity against the skin flora with percentage bacterial count reduction rates of 98.3% and 96.0% after skin preparation and after surgery respectively. These findings are statistically significant with P-values less than 0.001 using the Paired T-test. SSI rate after the surgery was 4.4% and Staphylococcus aureus was the organism implicated in 80% of the cases of SSI.
Conclusion: Staphylococcus species were the flora found in the groin region of the children in this study. Alcoholic chlorhexidine, a skin preparation antiseptic, is effective in significantly reducing bacterial colony count and SSI rate in the groin.