Distribution of the antiseptic resistance genes qacA, qacB and qacC in 497 methicillin-resistant and -susceptible European isolates of Staphylococcus aureus

Mayer, S.

doi:10.1093/jac/47.6.896

Cited by 162 publications

(115 citation statements)

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“…The difference between QacB and QacA is a single amino acid substitution at position 323, leading to a lower resistance level of biguanidines and diamidine in QacB (13). In this study, we found that fewer MSSA isolates harbor qacA/B (3.3%) or smr (5%) than MRSA isolates (43.8% and 25%, respectively), which is similar to the results of a previous report (9). The reason for more MRSA isolates with qacA/B or smr may be more selective pressures due to wide applications of chlorhexidine in clinical procedures.…”

Section: Resultssupporting

confidence: 90%

“…The reason for more MRSA isolates with qacA/B or smr may be more selective pressures due to wide applications of chlorhexidine in clinical procedures. The coexistence of qacA/B with multiresistant genes such as those encoding ␤-lactamase and heavy metal-resistant enzymes on the same plasmid may also be a contributing factor (9). Concomitant resistance to a range of antimicrobial agents could make MRSA isolates a better fit in hospital environments.…”

Section: Resultsmentioning

confidence: 99%

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High Rate of qacA - and qacB -Positive Methicillin-Resistant Staphylococcus aureus Isolates from Chlorhexidine-Impregnated Catheter-Related Bloodstream Infections

et al. 2012

Antimicrob Agents Chemother

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Chlorhexidine has been widely used for infection control. Although the use of chlorhexidine-impregnated catheters has reduced catheter-related infections, chlorhexidine-resistant Staphylococcus aureus has emerged. The correlation between the existence of the chlorhexidine-resistant genes qacA and qacB (qacA/B) in methicillin-resistant Staphylococcus aureus (MRSA) isolates and the effectiveness of chlorhexidine-impregnated catheters in the prevention of MRSA infections is unknown. Sixty methicillinsensitive Staphylococcus aureus (MSSA) and 96 MRSA isolates from the blood cultures of different patients were collected, and a case-control study was conducted to determine whether more clinical S. aureus isolates from chlorhexidine-impregnated catheter-related bloodstream infections (CRBSI) have the biocide-resistant genes (qacA/B or smr) than those from other infections. The chlorhexidine MIC 50 s of MSSA and MRSA isolates were 1 g/ml and 2 g/ml, respectively. Results of PCR analyses showed that 3.3% (n ‫؍‬ 2) of MSSA and 43.8% (n ‫؍‬ 42) of MRSA isolates harbored qacA/B and 5% (n ‫؍‬ 3) of MSSA and 25% (n ‫؍‬ 24) of MRSA isolates contained smr. With multivariate logistic regression analyses, the significant risk factors for definite CRBSI with chlorhexidine-impregnated catheters were determined to be S. aureus isolates with qacA/B and a chlorhexidine MIC of >2 g/ml (odds ratios [OR], 9.264 and 8.137, respectively, in all 156 S. aureus isolates and 6.097 and 4.373, respectively, in the 96 MRSA isolates). Further prospective studies are needed to investigate the transmission of these biocide-resistant genes.

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Section: Resultssupporting

confidence: 90%

Section: Resultsmentioning

confidence: 99%

High Rate of qacA - and qacB -Positive Methicillin-Resistant Staphylococcus aureus Isolates from Chlorhexidine-Impregnated Catheter-Related Bloodstream Infections

et al. 2012

Antimicrob Agents Chemother

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“…The rate of 80% of qacA/B in 74 Brazilian MRSA isolates is much higher than 45.9% found in Japan by Noguchi et al (2006), who performed their studies using 207 MRSA strains collected between 1999 and 2004, and it is even higher than 63% found in Europe by Mayer et al (2001) in 297 MRSA strains isolated between 1997 and 1999.…”

mentioning

confidence: 72%

“…Nucleotide sequences were aligned with the clustal X program version 1.8/22. The comparison showed the identity of 100% for six of the eight isolates and the other two isolates showed 99% of identity confirming they all harbored that gene, and both nucleotide sequences were submitted to GenBank available under accession numbers EF418547 and EF418548.The rate of 80% of qacA/B in 74 Brazilian MRSA isolates is much higher than 45.9% found in Japan by Noguchi et al (2006), who performed their studies using 207 MRSA strains collected between 1999 and 2004, and it is even higher than 63% found in Europe by Mayer et al (2001) in 297 MRSA strains isolated between 1997 and 1999.We underline the importance of our result since it is the first time that the presence of qacA/B is being reported for Brazilian MRSA strains as well as in so high rate. We call attention to the fact that if the qacA/B gene is present at 80% of those MRSA, carefulness of controlling their survival in the hospital environment must be considered since the high prevalence of qacA/B gene might be either due selective pressure imposed by the large use of QACs disinfectant or due the cross-resistance and co-resistance between QACs and antibiotics (Sidhu et al 2002).…”

mentioning

confidence: 87%

The presence of qacA/B gene in Brazilian methicillin-resistant Staphylococcus aureus

Miyazaki

Abreu

Marin

et al. 2007

Mem. Inst. Oswaldo Cruz

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The methicillin-resistant Staphylococcus aureus (MRSA) strains, which characterize for being resistant to multiple antibiotics, have become one of the most important nosocomial pathogens causing considerable morbidity and mortality in hospitals (Hiramatsu et al. 2001). Clinical isolates of MRSA carry the mecA gene that codes for a penicillin-binding protein (PBP) referred to PBP2a or PBP2', an inducible 78-kDa PBP. In susceptible strains there is no mecA gene homolog (Chambers 1997). The transmission of some important nosocomial pathogens including MRSA has been linked to environmental contamination and since outbreaks of hospital infections due to MRSA first became a serious problem, counter measures have concentrated on the prevention of infection rather than on medical treatment (Noguchi et al. 1999).One of the essential measures of hospital infection control is the use of disinfectants for inanimate objects and surfaces, and antiseptics for topical living tissue applications (McDonnell & Russell 1999). Disinfectants and antiseptics containing quaternary ammonium compounds (QAC) are extensively used in health care settings, and some data suggest that MRSA strains may exhibit decreased susceptibility to QAC by qac determinants, which confer resistance through efflux pumps that are membrane-bound, proton-motive force-dependent cation export protein (Chapman 2003). In clinical staphylococci, qac resistance determinants have been detected on plasmids carrying various antibiotic resistance genes. The large numbers of chemotherapeutic agents employed into clinical practice resulted in the development and spread of antibiotic resistance determinants among bacterial populations. Concerns have arisen regarding the potential emergence of cross-resistance and co-resistance between widely used disinfectants and antibiotics (Noguchi et al. 1999).The purpose of the present study was to investigate the qacA/B determinant distribution among 74 clinical MRSA isolated from Hospitals RJ-A, RJ-B, and RJ-C located in Rio de Janeiro during the years of 2002 and 2003.To identify the isolates, after Gram staining, coagulase and catalase detection, the staphylococci were characterized to the species level on the basis of a APIStaph kit (bioMérieux, France).Total genomic DNA of the microorganisms in this study was extracted using Dneasy Tissue Kit (Qiagen Inc., Valencia, CA). The MRSA strains were confirmed through the presence of mecA gene by polymerase chain reaction (PCR) technique that is so far regarded as the gold standard method for the detection of methicillin resistance. The nucleotide sequences of the primers used for this detection are listed in the Table and S. aureus ATCC 25923 and ATCC 33591 were used respectively as negative and positive control organisms for mecA gene in PCR. The mecA gene was detected in all 74 isolates (100%), which confirms that they were MRSA.Concerning to the detection of qacA/B gene the nucleotide sequences of the primers are listed in the Table. The qacA/B gene was found in 59 (80%) of the 74 MR...

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“…For instance, the linkage between resistance to trimethoprim (dfrA), β-lactams (blaZ), aminoglycosides (aacA-aphD) and antiseptics (qacC) mediated by a multi-resistance plasmid was reported in staphylococci (Weigel et al 2003). In S. aureus, it is known that the qacA/B genes frequently occur on the pSK1 and β-lactamase/heavy metal-resistance plasmids which also confer resistance to a range of antibiotics (Mayer et al 2001). In Gram-negative bacteria, the qac genes are often linked with plasmid-mediated class 1 integrons which harbour a variety of antibiotic resistance genes (Zhao et al 2012).…”

Section: The Qac Genes and Resistance To Antibioticsmentioning

confidence: 99%

Genetic basis of resistance to quaternary ammonium compounds - the qac genes and their role: a review

Jaglič¹,

Cervinkova²

2012

Vet. Med. - Czech

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ABSTRACT:Although the qac genes are named after one of their main substrates (i.e., quaternary ammonium compounds), these genes also code for resistance to a broad spectrum of other cationic compounds such as intercalating dyes, diamidines and biguanides. The various Qac proteins are involved in relatively low specific effluxbased multidrug pumps and belong to a family of small multidrug resistance proteins. Even though the practical significance of qac-mediated resistance lies mainly in resistance to antiseptics, contradictory findings on this issue are still reported. Therefore, the aim of this review is to summarise the current knowledge on qac-mediated resistance with special emphasis on resistance to antiseptics and its relevance for practice.

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Distribution of the antiseptic resistance genes qacA, qacB and qacC in 497 methicillin-resistant and -susceptible European isolates of Staphylococcus aureus

Cited by 162 publications

References 4 publications

High Rate of qacA - and qacB -Positive Methicillin-Resistant Staphylococcus aureus Isolates from Chlorhexidine-Impregnated Catheter-Related Bloodstream Infections

High Rate of qacA - and qacB -Positive Methicillin-Resistant Staphylococcus aureus Isolates from Chlorhexidine-Impregnated Catheter-Related Bloodstream Infections

The presence of qacA/B gene in Brazilian methicillin-resistant Staphylococcus aureus

Genetic basis of resistance to quaternary ammonium compounds - the qac genes and their role: a review

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