Distribution of chlorhexidine resistance genes among Staphylococcus aureus clinical isolates: the challenge of antiseptic resistance.

IF 1.7 Q3 INFECTIOUS DISEASES
GERMS Pub Date : 2022-12-31 eCollection Date: 2022-12-01 DOI:10.18683/germs.2022.1352
Amira M Sultan, Mohammad A Ahmed
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引用次数: 0

Abstract

Introduction: Chlorhexidine is an antiseptic agent which is extensively used to prevent nosocomial infections; however, this could result in reduction of its susceptibility. The aim of this work was to determine chlorhexidine susceptibility among Staphylococcus aureus isolates and to detect qacA/B and smr antiseptic resistance genes among these isolates. Furthermore, we aimed to identify possible risk factors for the reduction of chlorhexidine susceptibility among S. aureus isolates.

Methods: Various clinical samples were collected from patients with evidence of S. aureus infection. Antimicrobial susceptibilities of identified S. aureus isolates were determined by disk diffusion method. Resistance to methicillin was identified by cefoxitin disk diffusion test besides mecA gene detection by PCR. Chlorhexidine minimum inhibitory concentration (MIC) values were measured by broth microdilution method while qacA/B and smr resistance genes were detected by multiplex PCR.

Results: A total percentage of 25.9% of S. aureus isolates showed reduced susceptibility to chlorhexidine. Methicillin resistant S. aureus (MRSA) had a reported percentage of 39.5%, which was significantly higher than the 11.3% reported for methicillin susceptible S. aureus (MSSA), p<0.001. S. aureus isolates were found to harbor qacA/B and smr genes at 23.2% and 7.7% respectively. Risk factors for reduced susceptibility to chlorhexidine included; ICU setting (OR=2.02, 95%CI: 0.3-1.6), prolonged ICU stay (OR=1.7, 95%CI: 0.4-1.1), presence of central vascular catheter (OR=2.3, 95%CI: 0.2-1.9), mechanical ventilation (OR=1.88, 95%CI: 0.4-1.7) and acquisition of qacA/B (OR=15.7, 95%CI: 3.4-12.1) or smr gene (OR=15.7, 95%CI: 3.4-12.1).

Conclusions: Our work highlighted the current challenge of antiseptic resistance in our locality. The frequencies of qacA/B and smr genes were significantly higher among MRSA than MSSA isolates. About two thirds of chlorhexidine tolerant isolates displayed an MDR profile. To maintain chlorhexidine efficiency, biocidal stewardship program and ongoing surveillance are essential.

金黄色葡萄球菌临床分离株氯己定耐药基因的分布:抗菌剂耐药性的挑战。
氯己定是一种广泛用于预防医院感染的防腐剂;然而,这可能导致其易感性降低。本研究的目的是测定金黄色葡萄球菌对氯己定的敏感性,并检测这些金黄色葡萄球菌的qacA/B和smr耐药基因。此外,我们旨在确定金黄色葡萄球菌分离株对氯己定敏感性降低的可能危险因素。方法:收集有金黄色葡萄球菌感染证据的患者的各种临床标本。采用纸片扩散法对分离的金黄色葡萄球菌进行了药敏试验。除PCR检测mecA基因外,采用头孢西丁纸片扩散试验鉴定对甲氧西林的耐药性。采用微量肉汤稀释法测定氯己定最小抑制浓度(MIC),采用多重PCR法检测qacA/B和smr耐药基因。结果:25.9%的金黄色葡萄球菌对氯己定敏感性降低。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为39.5%,明显高于耐甲氧西林金黄色葡萄球菌(MSSA)的11.3%,其中含有qacA/B和smr基因的金黄色葡萄球菌分别为23.2%和7.7%。降低氯己定易感性的危险因素包括;ICU环境(OR=2.02, 95%CI: 0.3-1.6)、ICU住院时间延长(OR=1.7, 95%CI: 0.4-1.1)、是否存在中央血管导管(OR=2.3, 95%CI: 0.2-1.9)、机械通气(OR=1.88, 95%CI: 0.4-1.7)、是否获得qacA/B (OR=15.7, 95%CI: 3.4-12.1)或smr基因(OR=15.7, 95%CI: 3.4-12.1)。结论:我们的工作突出了目前在我们当地的抗菌剂耐药性的挑战。MRSA中qacA/B和smr基因的频率明显高于MSSA。大约三分之二的氯己定耐受菌株显示耐多药谱。为了保持氯己定的有效性,杀菌剂管理计划和持续监测是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
自引率
5.00%
发文量
36
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