Distribution of Biocide Resistance Genes and Association with Clonal Complex Genotypes in Staphylococcus aureus Isolated from School-Age Children in Guangzhou

Abstract

Purpose Chlorhexidine and mupirocin are often prescribed to children in affected communities to prevent colonization and transmission of Staphylococcus aureus , but this has led to an increasing rate of biocide resistance. In this study, we aimed to determine the distribution of biocide resistance genes among S. aureus isolates from school-age children in Guangzhou, investigate chlorhexidine gluconate and mupirocin susceptibility and clonal complex (CC) genotypes in strains carrying biocide-resistance genes, and further explore the role of biofilms in this resistance. Patients and Methods Antibiotic resistance and multilocus sequence genotyping were performed on 722 S. aureus isolates from previous study. The distribution of nine biocide genes ( qacA/B, mupA, mepA, sepA, norA, lmrS, smr, mupB, qacG ) was determined by PCR. Isolates carrying qacA/B or mupA genes were further tested for susceptibility to chlorhexidine gluconate (CHG) and mupirocin and biofilm formation abilities. Results The most prevalent of the nine biocide resistance genes were mepA (95.57%), followed by norA (78.81%), lmrS (77.01%), and sepA (58.17%). The qacG gene was not detected. Distribution of sepA was significantly decreased in CC30 and CC45 genotypes, and presence of sepA was associated with resistance to antibiotics such as CLI, ERY, TCY, SXT, CIP, and LVX. In addition, 64 (94.1%, n=68) qacA/B + isolates showed CHG resistance, 12 (100.0%, n=12) mupA + isolates were mupirocin resistant, and 4 (80%, n=5) and 5 (100%, n=5) qacA/B + mupA + isolates were CHG and mupirocin resistant, respectively. Of these 85 isolates, 98.8% (n=84) had different degrees of biofilm-forming abilities, which were positively associated with CHG and mupirocin resistance. Conclusion The distribution of biocide resistance genes was associated with special CCs. The qacA/B and mupA genes are highly associated with resistance to CHG and mupirocin, and biofilm formation was found to contribute to this biocide resistance.

Genetic Complexity of CC5 Staphylococcus aureus Isolates Associated with Sternal Bursitis in Chickens: Antimicrobial Resistance, Virulence, Plasmids, and Biofilm Formation

“…All isolates carried the multidrug resistance efflux pumps arl R, arl S, nor A, mep A, mep R, mgr A, and lmr S. All isolates harbored the lmr S, nor A, and mep A genes, with two of them also containing the qac G gene, which may also confer resistance to biocides. Chromosomally encoded efflux genes like mep A, nor A, and lmr S have been noted for their role in conferring multidrug and biocide resistance to bacteria, aiding in their survival under harsh conditions [ 67 ]. On the other hand, plasmid-mediated genes such as qac A/B encode proteins belonging to a major facilitator superfamily, while genes like qac G encode members of a small multidrug resistance family, which serve as the primary proteins for multidrug resistance efflux pumps [ 67 ].…”

“…Chromosomally encoded efflux genes like mep A, nor A, and lmr S have been noted for their role in conferring multidrug and biocide resistance to bacteria, aiding in their survival under harsh conditions [ 67 ]. On the other hand, plasmid-mediated genes such as qac A/B encode proteins belonging to a major facilitator superfamily, while genes like qac G encode members of a small multidrug resistance family, which serve as the primary proteins for multidrug resistance efflux pumps [ 67 ]. In animal husbandry, biocides like QACs find widespread usage [ 68 ].…”