Abstract
The purpose of this study was to investigate the resistance and virulence markers in microbial strains isolated from the hospital environment, recovered after surfaces decontamination with quaternary ammonium compounds, triclosan, iodine disinfectants, in order to predict their role in healthcare-associated infections. The resistance phenotypes were established using disk diffusion and double-disk diffusion test. Simplex and multiplex PCR assays were used to identify the genetic support of cell-associated and soluble virulence factors The Gram-negative bacterial strains isolated from hospital surfaces after decontamination were resistant in high proportions to beta-lactam antibiotics, including penicillins and associations with beta-lactamase inhibitors, third and fourth generation cephalosporins and carbapenems (encoded by blaTEM, blaNDMlike blaCTX-Mlike, blaOXA-48like genes), quinolones (QnrA, gyrB, parE genes), aminoglycosides (aac3Ia gene), and tetracyclines. Regarding the virulence profiles, P. aeruginosa strains revealed the plcH gene (86.6%) followed by plcH, ExoS, algD and ExoU, while the Enterobacteriaceae strains, fimH (24%), followed by papC, sfaDE, hlyA, cnf1, eaea and VT2 genes. S. aureus isolates revealed the SCCmec cassette of type II (40%), followed by type V, IIIA and type IV (2B) and the clfA, clfB, and can adhesion genes. These findings demonstrate that incorrect practices in biocides use, regarding contact time and concentrations or instruments and surfaces insufficient cleaning before disinfection can decrease their effect and favor the persistence of resistant and virulent microbial strains in the hospital environment. The multiple drug resistance and virulence determinants, encoded by diverse genetic elements suggest the potential of these strains to persist and initiate hospital-associated infections.
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