De La Cruz, K. | Search bioRxiv

bioRxiv2025

Establishing an ex vivo porcine skin model to investigate the effects of broad spectrum antiseptic on viable skin microbial communities

Incomplete antiseptic efficacy against potentially pathogenic microbial taxa places some patients at disproportionate risk for developing a surgical site infection. Laboratory models capable of interrogating the effects of antiseptics on the skin and its complex microbial communities are desperately needed to improve and better tailor antiseptic formulations. This work aims to establish an ex vivo porcine skin model to explore the impact of topical antiseptics on complex skin microbial communities and superficial skin lipids. Microbiome samples were treated with propidium-monoazide to selectively evaluate DNA from viable microorganisms. Bacterial abundances were assessed via viability-qPCR and quantitative culture. Viable community populations were evaluated with 16S rRNA gene sequencing. Epidermal biopsies were collected at multiple timepoints for lipidomic assessment via LC/MS. The ex vivo environment promoted shifts in porcine skin lipid composition and microbial communities over the experiments duration. Compared to water treated control skin, skin treated with the antiseptic chlorhexidine gluconate had significantly lower culturable and bioburden determined by viability-qPCR. Compared to water treated skin, viable microbial communities on CHG treated skin displayed greater relative abundance of several gut associated and Gram-negative bacterial taxa, including SMB53, Turicibacter, Pseudomonas and Proteus. Collectively these findings highlight the utility of an ex vivo porcine skin system for interrogating the impacts of antimicrobial disruption to complex microbial ecosystems, and ultimately for the future testing and development of improved antiseptic formulations.

microbiology↗

bioRxiv2024

Still Not Sterile: Chlorhexidine gluconate treatment does not completely reduce skin microbial bioburden and promotes pathogen overabundance in patients undergoing elective surgeries.

Surgical site infections (SSI) continue to occur despite widespread adoption of surgical antiseptics. The effects of chlorhexidine gluconate (CHG)-based antiseptics on the skin microbiome also remains undefined due to confounding effects of CHG persistence on skin. Patients undergoing elective surgery were enrolled to characterize the immediate and long-term impact of pre-surgical preparation with CHG antiseptic on skin microbial communities. Due to the broad-spectrum antimicrobial activity of CHG and its propensity to bind extracellular DNA, methods to selectively identify live microorganisms are critical to this process and to fully elucidate the effectiveness of pre-surgical protocols and potential disruptions to the healthy skin microbiome. Swabs of the surgical site skin microbiome were collected at multiple timepoints before and after surgery. Microbial bioburden and community compositions were evaluated with viability qPCR and 16S ribosomal RNA gene profiling. Pre-operative CHG induced a measurable reduction in the viable microbial bioburden at the surgical site. On the day of surgery, surgical sites displayed a significant increase in the relative abundance of several SSI associated bacterial genera, including, Acinetobacter, Bacillus, Escherichia-Shigella, and Pseudomonas, compared to baseline. Bacillus species isolated from subjects at baseline showed resistance to CHG with MICs exceeding 1000 {micro}g/ml. Despite major shifts in the skin microbiome upon exposure to CHG, they were transient in the majority of individuals. Skin microbial community structure recovered by the post-surgical follow-up. In short, this study shows that pre-surgical application of CHG can significantly reduce viable skin microbial bioburden, however, complete sterility is not achieved. While CHG induces temporary shifts in the skin microbiome, including enrichment for potentially pathogenic taxa, the skin microbiome recovers back to near baseline. Collectively, these findings identify tangible avenues for improving antiseptic formulations and offer further support that the skin microbiome is viable, stable, and resilient to chemical perturbation.

microbiology↗