SELECTION OF DECAMETHOXINE RESISTANT VARIANTS OF MICROORGANISMS WHILE USING QUATERNARY AMMONIUM COMPOUNDS UNDER CLINICAL CONDITIONS FOR 50 YEARS (1972-2022)

Abstract

Antiseptic decamethoxine (decasan), which belongs to quaternary ammonium compounds,has been used in the form of aqueous, aqueous- alcoholic, alcoholic, aqueous- glycerin, and glycerin solutions in clinical practice since 1969. Experimental studies of theformation rate of Staphylococci (S. aureus 209-Р, S. epidermidis) resistance showed thatover 30 passages, the resistance of Staphylococci increases 16-64 times, which indicatesthe possibility of formation of resistant forms of microbiota in relation to decamethoxineantiseptic in clinical conditions.Purpose of the work – to analyze the formation of opportunistic resistance of microbiota,the causative pathogens of infectious and inflammatory processes, over a period of 50years of local application in clinical conditions of the antiseptic decamethoxine – dekasanin the departments of a surgical profile (surgical, gynecological, otorhinolaryngological,etc.).Materials and methods. Analysis of sensitivity to the antiseptic decamethoxine[1, 10-Decamethylene-bis (N1, N1-dimethylmentoxycarbonylmethyl) – ammoniumdichloride], which belongs to quaternary ammonium compounds was carried out inrelation to isolated and identified clinical and reference global strains of opportunisticmicroorganisms belonging to different taxonomic groups of bacteria and yeast-likefungi of the genus Candida. The level of antimicrobial activity was determined by themethod of successive two-fold serial dilutions in a liquid environment optimal for the testmicrobe. The establishment of bacteriostatic (fungistatic) and bactericidal (fungicidal)concentrations of the antiseptic was repeated three times.Results. The sensitivity of the reference test strains remained practically unchangedin the minimum bacteriostatic concentration for 50 years. The minimum bacteriostaticconcentration of decamethoxine in relation to clinical strains of S. aureus, over 50 yearsof use – increased by 13.46 times, and in relation to S. epidermidis – by 8.14 times. Thesensitivity of clinical strains of S. pyogenes was reduced by 5.42-3.63 times; as for S.anginosus, resistance to decamethoxine increased by 3.07-1.62 times. Clinical strainsof S. mitis, which is mainly responsible for the formation of dental caries, also acquiredresistance by 2.21-2.62 times, respectively, and the resistance of E. faecalis increased by3.10-1.90 times. The resistance of C. albicans increased by more than 2 times during thestudied period, and C. tropicalis – by 1.94 times.Conclusions. The antibacterial activity of decamethoxine (decasan) against standardtest strains of bacteria of the genera Staphylococcus, Streptococcus, Escherichia,Pseudomonas, and yeast-like fungi of the genus Candida is stable when these test strainsare stored in laboratory conditions without contact with an antiseptic for 50 years. The useof the antiseptic decamethoxine (decasan) in clinical conditions for 50 years (1972-2022)leads to the formation of different levels of resistance of gram-positive (2.21-13.46 timesincrease in the minimum bacteriostatic (MBsC) concentration) and gram-negative(increase of MBsC 1,25-3.38 times, MBcC 1.49-2.21 times) of bacteria. Decamethoxineresistant variants of yeast-like fungi of the genus Candida are slowly formed. Fungistaticresistance increases 1.94-2.23 times, fungicidal resistance 1.73-2.09 times. The resistanceof bacteria and yeast-like fungi of the genus Candida to decamethoxine (decasan) developsby mutation after short-term, single and multiple contacts in clinical conditions withoutnoticeable changes in the biological characteristics of bacteria (Staphylococcus), whichmakes it possible to state that mutations are not directional and are not associated withan antiseptic, and play the role of only a selective agent.