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Antimicrobial Resistance & Infection Control
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Open Access 01-12-2017 | Research

Frequency of antiseptic resistance genes in clinical staphycocci and enterococci isolates in Turkey

Authors: Seyda Ignak, Yasar Nakipoglu, Bulent Gurler

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2017

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Abstract

Background

Disinfectants and antiseptics are biocides widely used in hospitals to prevent spread of pathogens. It has been reported that antiseptic resistance genes, qac’s, caused tolerance to a variety of biocidal agents, such as benzalkonium chloride (BAC) and chlorhexidine digluconate (CHDG) in Staphylococcus spp. isolates. We aimed to search the frequency of antiseptic resistance genes in clinical Staphylococcus spp. and Enterococcus spp. isolates to investigate the possible association with antiseptic tolerance and antibiotic resistance.

Methods

Antiseptic resistance genes (qacA/B, smr, qacG, qacH, and qacJ) isolated from Gram-positive cocci (69 Staphylococcus spp. and 69 Enterococcus spp.) were analyzed by PCR method. The minimum inhibitory concentrations (MICs) of BAC and CHDG were determined by agar dilution method, whereas antibiotic susceptibility was analyzed by disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) criteria.

Results

The frequency of antiseptic resistance genes was found to be high (49/69; 71.0%) in our clinical staphylococci isolates but absent (0/69; 0%) in enterococci isolates. The frequency of qacA/B and smr genes was higher (25/40; 62.5% and 7/40; 17.5%, respectively) in coagulase negative staphylococci (CNS) when compared to Staphylococcus aureus strains (3/29; 10.3%, and 4/29; 13.8%, respectively). In contrast, the frequency of qacG and qacJ genes was higher (11/29; 37.9% and 8/29; 27.5%, respectively) in S. aureus than those of CNS (5/40; 12.5%, 10/40; 25.0%) strains. qacH was not identified in none of the strains. We found an association between presence of antiseptic resistance genes and increased MIC values of BAC (>4 μg/mL) in staphylococci and it was found to be statistically statistically significant (p < 0.01). We also showed that MICs of BAC and CHDG of vancomycin-resistant enterococci (VRE) isolates were significantly higher than those of vancomycin-susceptible enterococci (VSE) isolates (p < 0.01).

Conclusions

For our knowledge, our study is the first to investigate antiseptic resistance genes in enterococci and also qacG, qacH, and qacJ genes in staphylococci isolates in Turkey. Further studies are needed to revise the biocide policy and to support infection control programs to avoid the development of new resistance mechanisms.
Literature
1.
Casey AL, Lambert PA, Elliott TS. Staphylococci. Int J Antimicrob Agents. 2007;29:23–32.CrossRef
2.
Fisher K, Phillips C. The ecology, epidemiology and virulence of enterococcus. Microbiology. 2009;155:1749–57.CrossRefPubMed
3.
Alanis AJ. Resistance to antibiotics: are we in the post-antibiotic era? Arch Med Res. 2005;36:697–705.CrossRefPubMed
4.
McBain AJ, Rickard AH, Gilbert P. Possible implications of biocide accumulation in the environment on the prevalence of bacterial antibiotic resistance. J Ind Microbiol Biotechnol. 2002;29:326–30.CrossRefPubMed
5.
Gilbert P, Mcbain AJ. Potential impact of increased use of biocides in consumer products on prevalence of antibiotic resistance. Clin Microbiol Rev. 2003;16:189–208.CrossRefPubMedPubMedCentral
6.
Maillard JY. Antimicrobial biocides in the healthcare environment: efficacy, usage, policies and perceived problems. Ther Clin Risk Manag. 2005;1:307–20.PubMedPubMedCentral
7.
Mayer S, Boos M, Beyer A, Fluit AC, Schmitz FJ. Distribution of the antiseptic resistance genes qacA, qacB and qacC in 497 methicillin-resistant and susceptible European isolates of Staphylococcus Aureus. J Antimicrob Chemother. 2001;47:896–7.CrossRefPubMed
8.
Noguchi N, Suwa J, Narui K, Sasatsu M, Ito T, Hiramatsu K, Song JH. Susceptibilities to antiseptic agents and distribution of antiseptic-resistance genes qacA/B and smr of methicillin-resistant Staphylococcus Aureus isolated in Asia during 1998 and 1999. J Med Microbiol. 2005;54:557–65.CrossRefPubMed
9.
Bjorland J, Steinum T, Sunde M, Waage S, Heir E. Novel plasmid-borne gene qacJ mediates resistance to quaternary ammonium compounds in equine Staphylococcus Aureus, Staphylococcus Simulans and Staphylococcus Intermedius. Antimicrob Agents Chemother. 2003;47:3046–52.CrossRefPubMedPubMedCentral
10.
Vali L, Davies SE, Lai LLG, Dave J, Amyes SGB. Frequency of biocide resistance genes, antibiotic resistance and the effect of clorhexidine exposure on clinical methicillin resistant Staphylococcus Aureus isolates. J Antimicrob Chemother. 2008;61:524–32.CrossRefPubMed
11.
Liu Q, Liu M, Wu Q, Li C, Zhou T, Ni Y. Sensitivities to biocides and distribution of biocide resistance genes in quaternary ammonium compound tolerant Staphylococcus Aureus isolated in a teaching hospital. Scand J Infect Dis. 2009;41:403–9.CrossRefPubMed
12.
Miyazaki NH, Abreu AO, Marin VA, Rezende CA, Moraes MT, Villas Bôas MH. The presence of qacA/B gene in Brazilian methicillin-resistant Staphylococcus Aureus. Mem Inst Oswaldo Cruz. 2007;102:539–40.CrossRefPubMed
13.
Teixeira CF, Pereira TB, Miyazaki NH, Villas Boas MH. Widespread distribution of qacA/B gene among coagulase-negative staphylococcus spp. in Rio de Janeiro, Brazil. J Hosp Infect. 2010;75:333–44.CrossRefPubMed
14.
Leelaporn A, Paulsen IT, Tennent JM, Littlejohn TG, Skurray RA. Multidrug resistance to antiseptics and disinfectants in coagulase-negative staphylococci. J Med Microbiol. 1994;40:214–20.CrossRefPubMed
15.
Bjorland J, Steinum T, Kvitle B, Waage S, Sunde M, Heir E. Widespread distribution of disinfectant resistance genes among staphylococci of bovine and caprine origin in Norway. J Clin Microbiol. 2005;43:4363–8.CrossRefPubMedPubMedCentral
16.
Ye HF, Zhang M, O'Donoghue M, Boost M. Are qacG, qacH and qacJ genes transferring from food isolates to carriage isolates of staphylococci? J Hosp Infect. 2012;80:95–6.CrossRefPubMed
17.
Bischoff M, Bauer J, Preikschat P, Schwaiger K, Mölle G, Hölzel C. First detection of the antiseptic resistance gene qacA/B in Enterococcus Faecalis. Microb Drug Resist. 2012;18:7–12.
18.
Meyer B, Cookson B. Does microbial resistance or adaptation to biocides create a hazard in infection prevention and control? J Hosp Infect. 2010;76:200–5.CrossRefPubMed
19.
Weber DJ, Rutala WA. Use of germicides in the home and the healthcare settings: is there a relationship between germicide use and antibiotic resistance? Infect Control Hosp Epidemiol. 2006;27:1107–19.CrossRefPubMed
20.
Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved Standard M7-A7. 7th ed. Wayne, PA: CLSI; 2006.
21.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Approved Standard M100-S17. Wayne, PA: CLSI; 2007.
22.
Noguchi N, Hase M, Kitta M, Sasatsu M, Deguchi K, Kono M. Antiseptic susceptibility and distribution of antiseptic resistance genes in methicillin-resistant Staphylococcus Aureus. FEMS Microbiol Lett. 1999;172:247–53.
23.
Wassenaar TM, Ussery D, Nielsen LN, Ingmer H. Review and phylogenetic analysis of qac genes that reduce susceptibility to quaternary ammonium compounds in Staphylococcus species. Eur J Microbiol Immunol (Bp). 2015;5:44–61.CrossRef
24.
Prag G, Falk-Brynhildsen K, Jacobsson S, Hellmark B, Unemo M, Söderquist B. Decreased susceptibility to chlorhexidine and prevalence of disinfectant resistance genes among clinical isolates of Staphylococcus Epidermidis. APMIS. 2014;122:961–7.CrossRefPubMed
25.
Nakipoğlu Y, Iğnak S, Gürler N, Gürler B. The prevalence of antiseptic resistance genes (qacA/B and smr) and antibiotic resistance in clinical Staphylococcus Aureus strains. Mikrobiyol Bul. 2012;46:180–9.PubMed
26.
Duran N, Temiz M, Duran GG, Eryılmaz N, Jenedi K. Relationship between the resistance genes to quaternary ammonium compounds and antibiotic resistance in staphylococci isolated from surgical site infections. Med Sci Monit. 2014;20:544–50.CrossRefPubMedPubMedCentral
27.
Aykan SB, Cağlar K, Engin ED, Sipahi AB, Sultan N, Yalınay ÇM. Investigation of the presence of disinfectant resistance genes qacA/B in nosocomial methicillin-resistant Staphylococcus Aureus isolates and evaluation of their in vitro disinfectant susceptibilities. Mikrobiyol Bul. 2013;47:1–10.CrossRefPubMed
28.
Longtin J, Seah C, Siebert K, McGeer A, Simor A, Longtin Y, Low DE, Melano RG. Distribution of antiseptic resistance genes qacA, qacB, and smr in methicillin-resistant Staphylococcus Aureus isolated in Toronto, Canada, from 2005 to 2009. Antimicrob Agents Chemother. 2011;55:2999–01.CrossRefPubMedPubMedCentral
29.
Alam MM, Ishino M, Kobayashi N. Analysis of genomic diversity and evolution of the low-level antiseptic resistance gene smr in Staphylococcus Aureus. Microb Drug Resist. 2003;9:1–7.CrossRef
30.
Zhang M, O’Donoghue MM, Ito T, Hiramatsu K, Boost MV. Prevalence of antiseptic-resistance genes in Staphylococcus Aureus and coagulase-negative staphylococci colonising nurses and the general population in Hong Kong. J Hosp Infect. 2011;78:113–7.CrossRefPubMed
31.
Bhardwaj P, Ziegler E, Palmer KL. Chlorhexidine induces VanA-type vancomycin resistance genes in enterococci. Antimicrob Agents Chemother. 2016;60:2209–21.CrossRefPubMedPubMedCentral
Metadata
Title
Frequency of antiseptic resistance genes in clinical staphycocci and enterococci isolates in Turkey
Authors
Seyda Ignak
Yasar Nakipoglu
Bulent Gurler
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2017
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-017-0244-6

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