Abstract
BackgroundHealthcare-associated infection (HAI) is a major public health problem. As a form of prevention and control, preparations of chlorhexidine are used extensively; however, the reduction of susceptibility to chlorhexidine has been reported. The aim of this study was to investigate the susceptibility to chlorhexidine and the distribution of the qacA/B genes in 211 clinical isolates of coagulase-negative Staphylococci (CoNS).MethodsCoNS were identified by conventional biochemical tests. Antimicrobial susceptibility was tested by disk-diffusion. Minimum inhibitory concentration (MIC) of chlorhexidine was determined by agar dilution test; detection of the qacA/B and mecA genes were evaluated by PCR.ResultsThe most frequently isolated species were S. epidermidis, S. hominis hominis, S. auricularis, and S. haemolyticus, respectively. The strains presented a multidrug resistance profile of 87%, including methicillin resistance. Reduced susceptibility to chlorhexidine was observed in 31%. The qacA/B genes were detected in samples resistant (32/32) and susceptible (17/32) to chlorhexidine. The vast majority (94%) of the samples with reduced susceptibility to chlorhexidine were multidrug resistant.ConclusionsOur results show that qacA/B genes are not restricted to strains expressing chlorhexidine resistance. Further studies are needed to understand how the expression of these genes occurs.
Highlights
Healthcare-associated infection (HAI) is a major public health problem
Coagulase -negative Staphylococci (CoNS) are among the main microorganisms involved in HAIs, bloodstream infections and infections related to the use of invasive medical devices [2]
The objective of the present study was to investigate the frequency of isolates with reduced susceptibility to chlorhexidine and to evaluate the distribution of the qacA/B genes in clinical samples of coagulase-negative Staphylococci
Summary
Healthcare-associated infection (HAI) is a major public health problem. The aim of this study was to investigate the susceptibility to chlorhexidine and the distribution of the qacA/B genes in 211 clinical isolates of coagulase-negative Staphylococci (CoNS). Healthcare-associated infections (HAIs) have become a serious problem for global public health [1]. Vale et al BMC Infectious Diseases (2019) 19:199 reaction (PCR) products are designated as qacA/B positive or negative [7]. Their functions consist of coding the proton-dependent efflux pump (QacA/QacB), a member of the major facilitator superfamily of transport proteins, organized into 14 α-helical transmembrane segments, capable of exporting chlorhexidine out of the bacteria. Some studies have suggested cross-resistance between the qacA/B genes and other antimicrobial agents, as the plasmids may carry multiple determinants of antimicrobial resistance, facilitating the maintenance of the strains in the hospital environment and their dissemination [8,9,10]
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