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Antimicrobial Agents and Chemotherapy, September 2002, p. 2797-2803, Vol. 46, No. 9
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.9.2797-2803.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Frequency of Disinfectant Resistance Genes and Genetic Linkage with ß-Lactamase Transposon Tn552 among Clinical Staphylococci

Maan Singh Sidhu,1 Even Heir,2 Truls Leegaard,2 Karianne Wiger,2 and Askild Holck1*

MATFORSK, Norwegian Food Research Institute, N-1430 Ås,1 Division of Infectious Disease Control, Norwegian Institute of Public Health, N-0403 Oslo, Norway2

Received 3 December 2001/ Returned for modification 24 March 2002/ Accepted 21 May 2002

A total of 61 strains of Staphylococcus aureus and 177 coagulase-negative staphylococcal strains were isolated from the blood of patients with bloodstream infections and from the skin of both children under cancer treatment and human immunodeficiency virus-positive patients. The MIC analyses revealed that 118 isolates (50%) were resistant to quaternary ammonium compound-based disinfectant benzalkonium chloride (BC). The frequencies of resistance to a range of antibiotics were significantly higher among BC-resistant staphylococci than among BC-sensitive staphylococci. Of 78 BC-resistant staphylococcal isolates, plasmid DNA from 65 (83%), 2 (3%), 43 (55%), and 15 (19%) isolates hybridized to qacA or -B (qacA/B), qacC, blaZ, and tetK probes, respectively. The qacA/B and blaZ probes hybridized to the same plasmid in 19 (24%) staphylococcal strains. The plasmids harboring both qacA/B and blaZ genes varied from approximately 20 to 40 kb. The Staphylococcus epidermidis Fol62 isolate, harboring multiresistance plasmid pMS62, contained qacA/B and blaZ together with tetK. Molecular and genetic studies indicated different structural arrangements of blaZ and qacA/B, including variable intergenic distances and transcriptional directions of the two genes on the same plasmid within the strains. The different organizations may be due to the presence of various genetic elements involved in cointegration, recombination, and rearrangements. These results indicate that qac resistance genes are common and that linkage between resistance to disinfectants and penicillin resistance occurs frequently in clinical isolates in Norway. Moreover, the higher frequency of antibiotic resistance among BC-resistant strains indicates that the presence of either resistance determinant selects for the other during antimicrobial therapy and disinfection in hospitals.

* Corresponding author. Mailing address: MATFORSK, Norwegian Food Research Institute, Oslovn. 1, N-1430 Ås, Norway. Phone: 47 64 97 01 00. Fax: 47 64 97 03 33. E-mail: askild.holck{at}matforsk.no.

Antimicrobial Agents and Chemotherapy, September 2002, p. 2797-2803, Vol. 46, No. 9
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.9.2797-2803.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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