دورية أكاديمية
أعرض في EDS

Association of qacA/B and smr Carriage with Staphylococcus aureus Survival following Exposure to Antiseptics in an Ex Vivo Venous Catheter Disinfection Model.

التفاصيل البيبلوغرافية
العنوان: Association of qacA/B and smr Carriage with Staphylococcus aureus Survival following Exposure to Antiseptics in an Ex Vivo Venous Catheter Disinfection Model.
المؤلفون: McNeil JC; Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.; Texas Children's Hospital, Houston, Texas, USA., Sommer LM; Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.; Texas Children's Hospital, Houston, Texas, USA., Vallejo JG; Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.; Texas Children's Hospital, Houston, Texas, USA., Hulten KG; Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.; Texas Children's Hospital, Houston, Texas, USA., Kaplan SL; Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.; Texas Children's Hospital, Houston, Texas, USA.
المصدر: Microbiology spectrum [Microbiol Spectr] 2023 Mar 02, pp. e0333322. Date of Electronic Publication: 2023 Mar 02.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: ASM Press Country of Publication: United States NLM ID: 101634614 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2165-0497 (Electronic) Linking ISSN: 21650497 NLM ISO Abbreviation: Microbiol Spectr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Washington, DC : ASM Press, 2013-
مستخلص: Many health care centers have reported an association between Staphylococcus aureus isolates bearing efflux pump genes and an elevated MIC/minimal bactericidal concentration (MBC) to chlorhexidine gluconate (CHG) and other antiseptics. The significance of these organisms is uncertain, given that their MIC/MBC is typically far lower than the CHG concentration in most commercial preparations. We sought to evaluate the relationship between carriage of the efflux pump genes qacA/B and smr in S. aureus and the efficacy of CHG-based antisepsis in a venous catheter disinfection model. S. aureus isolates with and without smr and/or qacA/B were utilized. The CHG MICs were determined. Venous catheter hubs were inoculated and exposed to CHG, isopropanol, and CHG-isopropanol combinations. The microbiocidal effect was calculated as the percent reduction in CFU following exposure to the antiseptic relative to the control. The qacA/B- and smr -positive isolates had modest elevations in the CHG MIC 90 compared to the qacA/B- and smr -negative isolates (0.125 mcg/ml vs. 0.06 mcg/ml, respectively). However, the CHG microbiocidal effect was significantly lower for qacA/B - and/or smr -positive strains than for susceptible isolates, even when the isolates were exposed to CHG concentrations up to 400 μg/mL (0.04%); this finding was most notable for isolates bearing both qacA/B and smr (89.3% versus 99.9% for the qacA/B- and smr -negative isolates; P  = 0.04). Reductions in the median microbiocidal effect were also observed when these qacA/B- and smr -positive isolates were exposed to a solution of 400 μg/mL (0.04%) CHG and 70% isopropanol (89.5% versus 100% for the qacA/B- and smr -negative isolates; P  = 0.002). qacA/B - and smr- positive S. aureus isolates have a survival advantage in the presence of CHG concentrations exceeding the MIC. These data suggest that traditional MIC/MBC testing may underestimate the ability of these organisms to resist the effects of CHG. IMPORTANCE Antiseptic agents, including chlorhexidine gluconate (CHG), are commonly utilized in the health care environment to reduce rates of health care-associated infections. A number of efflux pump genes, including smr and qacA/B , have been reported in Staphylococcus aureus isolates that are associated with higher MICs and minimum bactericidal concentrations (MBCs) to CHG. Several health care centers have reported an increase in the prevalence of these S. aureus strains following an escalation of CHG use in the hospital environment. The clinical significance of these organisms, however, is uncertain, given that the CHG MIC/MBC is far below the concentration in commercial preparations. We present the results of a novel surface disinfection assay utilizing venous catheter hubs. We found that qacA/B -positive and smr -positive S. aureus isolates resist killing by CHG at concentrations far exceeding the MIC/MBC in our model. These findings highlight that traditional MIC/MBC testing is insufficient to evaluate susceptibility to antimicrobials acting on medical devices.
References: Am J Infect Control. 2009 Oct;37(8):626-30. (PMID: 19616869)
J Pediatric Infect Dis Soc. 2012 Dec;1(4):284-92. (PMID: 26619421)
Am J Infect Control. 2013 May;41(5 Suppl):S72-6. (PMID: 23622754)
N Engl J Med. 2013 Feb 7;368(6):533-42. (PMID: 23388005)
J Antimicrob Chemother. 2008 Jan;61(1):78-84. (PMID: 17981834)
Proc Natl Acad Sci U S A. 1996 Apr 16;93(8):3630-5. (PMID: 8622987)
Lancet Infect Dis. 2017 Apr;17(4):381-389. (PMID: 28089444)
J Pediatr. 2002 Apr;140(4):432-8. (PMID: 12006957)
Antimicrob Agents Chemother. 2010 Oct;54(10):4107-11. (PMID: 20660673)
Eur J Microbiol Immunol (Bp). 2015 Mar;5(1):44-61. (PMID: 25883793)
Microb Drug Resist. 2018 Apr;24(3):283-289. (PMID: 28799881)
FEMS Microbiol Lett. 1999 Mar 15;172(2):247-53. (PMID: 10188253)
Pediatr Infect Dis J. 2013 Feb;32(2):124-8. (PMID: 22976051)
Infect Control Hosp Epidemiol. 2022 May;43(5):553-569. (PMID: 35437133)
Pediatr Infect Dis J. 2003 Aug;22(8):686-91. (PMID: 12913767)
J Thorac Cardiovasc Surg. 2014 Jul;148(1):259-65. (PMID: 24113023)
Clin Infect Dis. 2007 May 1;44(9):1208-15. (PMID: 17407040)
Infect Control Hosp Epidemiol. 2010 Feb;31(2):183-90. (PMID: 20001603)
Br J Nurs. 2020 Jan 23;29(2):S24-S26. (PMID: 31972108)
J Appl Microbiol. 2005;98(3):533-43. (PMID: 15715855)
J Biol Chem. 1994 Nov 25;269(47):29998-30004. (PMID: 7962000)
J Med Microbiol. 2019 Jun;68(6):957-960. (PMID: 31050633)
Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78; quiz 279-80. (PMID: 10219875)
Gene. 1991 May 15;101(1):59-66. (PMID: 1840534)
Fed Regist. 2017 Dec 20;82(242):60474-503. (PMID: 29260839)
Antimicrob Agents Chemother. 2013 Jan;57(1):559-68. (PMID: 23147738)
Lancet. 2013 Mar 30;381(9872):1099-106. (PMID: 23363666)
Antimicrob Agents Chemother. 2015 Dec 14;60(2):1121-8. (PMID: 26666947)
Pediatrics. 2014 Oct;134(4):705-12. (PMID: 25201802)
Infect Control Hosp Epidemiol. 2014 Sep;35 Suppl 2:S21-31. (PMID: 25376067)
Antimicrob Agents Chemother. 2017 Jun 27;61(7):. (PMID: 28438928)
Clin Infect Dis. 2009 Jul 1;49(1):1-45. (PMID: 19489710)
J Antimicrob Chemother. 2008 Mar;61(3):524-32. (PMID: 18227090)
Infect Control Hosp Epidemiol. 2019 Mar;40(3):333-340. (PMID: 30887943)
J Hosp Infect. 1985 Dec;6(4):389-97. (PMID: 2868036)
Clin Infect Dis. 2011 May;52(9):e162-93. (PMID: 21460264)
Infect Control Hosp Epidemiol. 2016 May;37(5):590-7. (PMID: 26828094)
Mol Microbiol. 1990 Dec;4(12):2051-62. (PMID: 2089219)
J Hosp Infect. 1988 May;11(4):396-7. (PMID: 2899594)
Clin Infect Dis. 2010 Jan 15;50(2):210-7. (PMID: 20001537)
J Microbiol Methods. 2016 Jun;125:58-63. (PMID: 27080188)
Arch Intern Med. 2007 Oct 22;167(19):2073-9. (PMID: 17954801)
Clin Microbiol Rev. 1999 Jan;12(1):147-79. (PMID: 9880479)
Open Microbiol J. 2013;7:59-71. (PMID: 23569469)
Infect Control Hosp Epidemiol. 2012 Sep;33(9):889-96. (PMID: 22869262)
Int J Hyg Environ Health. 2006 Jan;209(1):89-95. (PMID: 16373206)
Int J Antimicrob Agents. 2012 Sep;40(3):204-9. (PMID: 22766161)
Infect Control Hosp Epidemiol. 2014 Sep;35(9):1183-6. (PMID: 25111928)
معلومات مُعتمدة: K23 AI099159 United States AI NIAID NIH HHS; R01 HS026896 United States HS AHRQ HHS
فهرسة مساهمة: Keywords: Staphylococcus aureus; chlorhexidine gluconate; disinfection; pediatric; qacA/B; smr
تواريخ الأحداث: Date Created: 20230302 Latest Revision: 20240216
رمز التحديث: 20240216
مُعرف محوري في PubMed: PMC10100659
DOI: 10.1128/spectrum.03333-22
PMID: 36862001
قاعدة البيانات: MEDLINE
الوصف
تدمد:2165-0497
DOI:10.1128/spectrum.03333-22