PP-012 Etiology and antibiotic resistance patterns in urinary tract infections among Nepalese patients

Abstract

Background: Widespread use of antiseptic agents has led to the emergence of Staphylococcus aureus and coagulasenegative staphylococci (CNS) with decreased antiseptic susceptibility. This has been associated with the presence of several genes including qacA/B and smr. This study determined the prevalence of antiseptic resistance genes in S. aureus and CNS from ATM machine. Methods: Swabs were collected from 400 ATM machines, cultured for the presence of S. aureus and CNS and identified by standard methods. PCR was used to detect 16S rRNA genes for staphylococci, MecA, qacA/B and smr. Univariate analyses were used to compare the prevalence of antiseptic resistant gene among different isolates. Results: 15.5% (62/400) of ATM machines were contaminated with S. aureus and 95.3% (381/400) with CNS. Overall MRSA carriage rate was low (0.5%, 2/400) with one SCCmec type IVa and one type V. There was a higher prevalence of qacA/B (26.0%, 99/381) and smr (13.9%, 53/381) in CNS compared to S. aureus (11.3% in qacA/B, 1.6% in smr). (p < 0.05). There was a significantly higher prevalence of qacA/B (27.3%, 27/99) in MRCNS strains than 11.7% (33/282) in MSCNS isolates (p < 0.001). Likewise, higher prevalence of qacA/B (28.6%, 2/7) in MRSA compared to MSSA (0/55). Conclusions: This is the first report of antiseptic resistance genes in environmental isolates outside the hospital. Both qacA/B genes and smr genes had higher prevalence in CNS than in S. aureus. The increased proportion of antiseptic resistance gene positivity in mecA positive isolates suggests co-selection of these genes. Contamination of ATM machines with strains with reduced antiseptic may increase risks of infection in the community. Increasing resistance to antiseptics, especially in MRSA may increase difficulties in infection control in the environment.