Reduced susceptibility to biocides in Acinetobacter baumannii: association with resistance to antimicrobials, epidemiological behaviour, biological cost and effect on the expression of genes encoding porins and efflux pumps.
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Fernández-Cuenca Felipe, Tomás María, Caballero-Moyano Francisco-Javier, Bou Germán, Martínez-Martínez Luis, Vila Jordi, Pachón Jerónimo, Cisneros José-Miguel, Rodríguez-Baño Jesús, Pascual Álvaro, Spanish Group of Nosocomial Infections (GEIH) from the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI), Spanish Group of Nosocomial Infections GEIH from the Spanish Society of Clinical Microbiology and Infectious Diseases SEIMC and the Spanish Network for Research in Infectious Diseases REIPI
Аннотация
METHODS: Susceptibility to biocides and antimicrobials was determined in 49 clonally unrelated isolates of A. baumannii. Biological cost, in terms of mean generation time, was determined by spectrophotometry. Quantitative real-time RT-PCR was used to determine the relative expression of genes encoding several efflux pumps and porins.
RESULTS: Reduced susceptibility to chlorhexidine digluconate, benzalkonium chloride and Irgasan(®) was associated with resistance to aminoglycosides, tetracycline and ciprofloxacin (P < 0.05). The MICs of carbapenems, aminoglycosides, doxycycline and ciprofloxacin for isolate Ab70 (epidemic clone) exposed to these biocides increased by ≥2 dilutions. Reduced susceptibility to Orsan(®) was more frequent among prevalent clones than non-prevalent clones (P < 0.05). Mean generation times for Ab70 before and after exposure to benzalkonium chloride were 57.8 and 78.1 min, respectively (P = 0.02). Relative expression of abeS and adeB was increased in Ab46 and Ab70 after exposure to chlorhexidine digluconate, but was decreased for ompA and carO after exposure to Irgasan(®).
CONCLUSIONS: Reduced susceptibility to biocides is associated with co-resistance to carbapenems, aminoglycosides, tetracycline and ciprofloxacin. Reduced susceptibility to Orsan(®) may be a marker of prevalent clones. Acquisition of reduced susceptibility to benzalkonium chloride has a biological cost. Exposure to biocides affects the relative expression of genes related to some efflux pump genes (increased expression) or porins (reduced expression).