Chlorhexidine resistance evolution in Neisseria gonorrhoeae

We report the first experimental evidence that sustained chlorhexidine exposure can result in reduced susceptibility to chlorhexidine in N. gonorrhoeae. Our results suggest that intense exposure to chlorhexidine may result in resistance associated mutations in N. gonorrhoeae in three different efflux pumps: the MATE, RND and ABC transporters. Exposure to sub-lethal chlorhexidine concentrations may not only enhance resistance to chlorhexidine itself but also cross-resistance to other antibiotics.