Frequency of Antiseptic Resistance Among Staphylococcus aureus and Coagulase-Negative Staphylococci Isolated From a University Hospital in Central Iran

Abstract

The carriage of several biocide resistance genes, including ,, and , alone or concurrently, is associated with reduced susceptibility. Use of antiseptics may select for antibiotic-resistant strains and assist their survival in the healthcare environment.

Comparative Genomics Study of Staphylococcus epidermidis Isolates from Orthopedic-Device-Related Infections Correlated with Patient Outcome

“…Our data also revealed that the antiseptic (quaternary ammonium compound) qacA gene was statistically more prevalent in the "not-cured" outcome group (P ϭ 0.023). The qacA gene is a plasmid-borne gene (pSK1 family plasmids) that confers resistance to antiseptics and disinfectants such as cetrimide, benzalkonium chloride, and chlorhexidine (30)(31)(32). Our observation that the qacA gene was present in 67.3% of isolates (89.5% of "not-cured" group isolates) within the complete cohort seems enriched compared to that in other studies for clinical (47% to 52%) and commensal (25%) S. epidermidis isolates (31,32).…”

“…The qacA gene is a plasmid-borne gene (pSK1 family plasmids) that confers resistance to antiseptics and disinfectants such as cetrimide, benzalkonium chloride, and chlorhexidine (30)(31)(32). Our observation that the qacA gene was present in 67.3% of isolates (89.5% of "not-cured" group isolates) within the complete cohort seems enriched compared to that in other studies for clinical (47% to 52%) and commensal (25%) S. epidermidis isolates (31,32). Despite the relatively high presence in our collection and a moderate number of "not-cured" isolates, there is some statistical significance to associate the presence of this gene with a poor treatment outcome.…”

Systematic Analysis of Efflux Pump-Mediated Antiseptic Resistance in Staphylococcus aureus Suggests a Need for Greater Antiseptic Stewardship

“…In terms of evolution of antiseptic resistance, it is important to consider that while qacA and qacC are typically horizontally acquired factors, norA exists as part of the core genome of S. aureus; qacA and qacC typically reside on a variety of conjugative and nonconjugative plasmids (18,42,49,50). Importantly, naturally occurring S. aureus isolates that concomitantly carry norA, qacA, and qacC have been documented (20)(21)(22)51). Unfortunately, the genome sequences of these strains are not available, so it is impossible to know whether genomic localization of the three genes follows the expected paradigm.…”

“…Besides norA, which has recently been shown to be part of the core genome of S. aureus (17), qacA and qacC reside on a variety of conjugative and nonconjugative plasmids (18,19). The majority of qac prevalence studies demonstrate that while qacA and qacC do not commonly coexist within S. aureus, the presence of all three efflux pumps within S. aureus isolates does occur (20)(21)(22); however, the functional consequences of harboring all three pumps are unknown. For S. aureus strains that carry either qacA or qacC, the prevalence varies greatly and depends on the geographical location and sample population being studied.…”

Representativeness of EN 1040/13727 Assay Conditions for Evaluating <i>In Vitro</i> the Bactericidal Activity of a Chlorhexidine Digluconate and Benzalkonium Chloride Antiseptic Preparation

“…Resistance to antiseptics, including chlorhexidine [1] [22], but also QACs [29] [30], is becoming a challenge, particularly in the presence of interfering substances. This phenomenon leads to the selection of microbicide-resistant bacteria.…”