Relationship between the resistance genes to quaternary ammonium compounds and antibiotic resistance in staphylococci isolated from surgical site infections

Duran, Nizami; Temiz, Muhyittin; Duran, Gülay Gülbol; Eryilmaz, Naciye; Jenedi, Kemal

doi:10.12659/msm.890177

Cited by 16 publications

(4 citation statements)

References 17 publications

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“…Many closed plasmid sequences were >100kbp long (>9%, n=536), repeat rich and present at low abundances in the microbiome, impeding their characterization using Illumina shotgun metagenomics. In particular, we noted the presence of a group of large mecA carrying plasmids that also contained antiseptic and disinfectant resistance genes (qacA or qacC), a combination that is not represented in existing databases 43 , but is in agreement with high biocide-resistant rates for MRSA that has been reported in clinical settings 44,45 .…”

Section: Nanopore Sequencing Reveals Distribution Of Pathogenomes In supporting

confidence: 64%

“…4). The enrichment of virulence factors (one-sided Wilcoxon p-value=0.027 for S. aureus) and the presence of multiple copies of disinfectant resistance genes 44,45 (as many as 3 copies of qacA in s2 and s3; Fig. 2d) in the genomes of shared multidrug resistant strains may enable them to successfully colonize both hospital environments and patients, and thus be readily transferred between them.…”

Section: Discussionmentioning

confidence: 99%

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Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Chng

Bertrand

et al. 2019

Preprint

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There is growing attention surrounding hospital acquired infections (HAIs) due to high associated healthcare costs, compounded by the scourge of widespread multi-antibiotic resistance. Although hospital environment disinfection is well acknowledged to be key for infection control, an understanding of colonization patterns and resistome profiles of environment-dwelling microbes is currently lacking. We report the first extensive genomic characterization of microbiomes (355), common HAI-associated microbes (891) and transmissible drug resistance cassettes (1435) in a tertiary hospital environment based on a 2-timepoint sampling of 179 sites from 45 beds. Deep shotgun metagenomic sequencing unveiled two distinct ecological niches of microbes and antibiotic resistance genes characterized by biofilm-forming and human microbiome influenced environments that display corresponding patterns of divergence over space and time. To study common nosocomial pathogens that were typically present at low abundances, a combination of culture enrichment and long-read nanopore sequencing was used to obtain thousands of high contiguity genomes (2347) and closed plasmids (5910), a significant fraction of which (>58%) are not represented in current sequence databases. These high-quality assemblies and metadata enabled a rich characterization of resistance gene combinations, plasmid architectures, and the dynamic nature of hospital environment resistomes and their reservoirs. Phylogenetic analysis identified multidrug resistant clonal strains as being more widely disseminated and stably colonizing across hospital sites. Further genomic comparisons with clinical isolates across multiple species supports the hypothesis that multidrug resistant strains can persist in the hospital environment for extended periods (>8 years) to opportunistically infect patients. These findings highlight the importance of characterizing antibiotic resistance reservoirs in the hospital environment and establishes the feasibility of systematic genomic surveys to help target resources more efficiently for preventing HAIs.

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Section: Nanopore Sequencing Reveals Distribution Of Pathogenomes In supporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Chng

Bertrand

et al. 2019

Preprint

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“…On the contrary, 70.9% of all MR-CoNS isolates in the present study carried the qac A/B gene. This prevalence was higher than the rate of the qac A/B gene carried by CoNS isolated from surgical sites (37.9%) [40], nurses (56.7%), and the general population in Hong Kong (13.5%) [23]. The increased proportion of the qac A/B gene in MR-CoNS indicates that hospital-acquired infections could exert selective pressure for carriage of these strains.…”

Section: Discussionmentioning

confidence: 98%

Molecular Characteristics of Methicillin-Resistant Staphylococci Clinical Isolates from a Tertiary Hospital in Northern Thailand

Kitti

Seng

Saiprom

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Methicillin-resistant staphylococci are now recognized as a major cause of infectious diseases, particularly in hospitals. Molecular epidemiology is important for prevention and control of infection, but little information is available regarding staphylococcal infections in Northern Thailand. In the present study, we examined antimicrobial susceptibility patterns, detection of antimicrobial resistance genes, and SCCmec types of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) isolated from patients in a hospital in Northern Thailand. The species of MRSA and MR-CoNS were identified using combination methods, including PCR, MALDI-TOF-MS, and tuf gene sequencing. The susceptibility pattern of all isolates was determined by the disk diffusion method. Antimicrobial resistance genes, SCCmec types, and ST239 were characterized using single and multiplex PCR. ST239 was predominant in MRSA isolates (10/23). All MR-CoNS (N=31) were identified as S. haemolyticus (N=18), S. epidermidis (N=3), S. cohnii (N=3), S. capitis (N=6), and S. hominis (N=1). More than 70% of MRSA and MR-CoNS were resistant to cefoxitin, penicillin, oxacillin, erythromycin, clindamycin, gentamicin, and ciprofloxacin. In MRSA isolates, the prevalence of ermA (78.3%) and ermB (73.9%) genes was high compared to that of the ermC gene (4.3%). In contrast, ermC (87.1%) and qacA/B genes (70.9%) were predominant in MR-CoNS isolates. SCCmec type III was the dominant type of MRSA (13/23), whereas SCCmec type II was more present in S. haemolyticus (10/18). Ten MRSA isolates with SCCmec type III were ST239, which is the common type of MRSA in Asia. This finding provides useful information for a preventive health strategy directed against methicillin-resistant staphylococcal infections.

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“…To date, two studies [ 26 , 27 ] have been published on the antiseptic resistance genes of staphylococci in Turkey in addition to our previous study in 2012 [ 25 ]. Duran et al [ 26 ] reported that the frequency of qacA/B and smr genes among amikacin-resistant S.aureus was 47.4% and 28.9% in Turkey, respectively, and this finding was statistically significant ( p < 0.05). In the same study, the frequency of qacA/B and smr in CNS was 37.9% and 20.7%, respectively ( p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

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

İgnak

Nakipoğlu

Gürler

2017

Antimicrob Resist Infect Control

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BackgroundDisinfectants 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.MethodsAntiseptic 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.ResultsThe 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).ConclusionsFor 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.

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Relationship between the resistance genes to quaternary ammonium compounds and antibiotic resistance in staphylococci isolated from surgical site infections

Cited by 16 publications

References 17 publications

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Molecular Characteristics of Methicillin-Resistant Staphylococci Clinical Isolates from a Tertiary Hospital in Northern Thailand

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

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