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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

2015; Oxford University Press; Volume: 70; Issue: 12 Linguagem: Inglês

10.1093/jac/dkv262

1460-2091

Felipe Fernández-Cuenca, María Tomás, Francisco-Javier Caballero-Moyano, Germán Bou, Luis Martínez‐Martínez, Jordi Vilà, Jerónimo Pachón, José Miguel Cisneros, Jesús Rodríguez‐Baño, Álvaro Pascual, José Garnacho, Antonio Gutiérrez‐Pizarraya, Juan Antonio Márquez-Vácaro, María Eliecer Cano, María Carmen Fariñas, Antonio Sánchez-Porto, Gloria Esteban Meruendano, Luis Barbeyto-Vales, Javier Casas-Ciria, Luis A. Vallejo, Begoña Fernández-Pérez, José Carlos Villar-Chao, Belén Padilla-Ortega, Emilia Cercenado-Mansilla, J.J. García-Irure, Alfonso del Arco, Concepción Gimeno Cardona, Juan Carlos Valía, Nuria Tormo, Vicente Abril, Josefina Rifa, Maria Martinez‐García, Joseph Vilaró-Pujals, Marian Navarro Aguirre, Ana Vilamala, José Antonio Jiménez-Alfaro, Carlos Reviejo-Jaca, P Casanova, Francisca Guerreo, Evelyn Shaw, Virginia Plasencia, Teresa Nebreda-Mayoral, María José Fernández-Calavia, Susana García de Cruz, Carmen Aldea-Mansilla, Esperanza Merino, Alfredo Zorraquino, Sergio Reus, Eugenio Garduno-Eseverri, Luis López Sánchez, Ana Fleites-Gutiérrez, Azucena Rodríguez-Guardado, Alfonso Blázquez Moreno, José María García-Arenzana Anguera, Serafín López-Palmero, Manuel Rodríguez-Maresca, Fernando Garcı́a-Garrote, José Varela-Otero, María del Pilar Alonso, Elisa Vidal-Verdú, Fernando Rodríguez, Fernanda Pardo-Sánchez, E. Ferrer-Vizoso, Benito Regueiro, Mercè Gurguí, Roser Pericas, Virginia Pomar, Pedro Olaechea‐Astigarraga, Rafael Ayarza-Igartua, María Dolores Maciá-Romero, Enrique Ruiz de Gopegui-Bordes, María Isabel Sánchez-Romero, Jesús García-Mata, M.J. Goyanes, Cristina Morales-Mateos, José Hernández‐Quero, Trinidad Escobar-Lara, Frederic Ballester-Bastardie, Simona Iftimie, Isabel Pujol, María Isabel Galán-Navarro, María de la Luz Cádiz‐Gurrea, Carmen Amores-Antequera, M.M. Ramírez Gómez, Purificación Cantudo, Carmina Martí-Salas, Jordi Cuquet-Peragosa, Antonio Moreno‐Flores, Luis Anibarro, Susana Hernando-Real, Pablo A. Carrero-González, María Angeles Pallarés-González, Sergio Rodríguez-Fernández, Miquel Pujol, Fé Tubau, Enrique Nuño-Álvarez, María Ortega-Torres, Salvador Giner-Almaraz, María Rosa Roca-Castelló, Manuela Sánchez Castillo, Elena Hortelano, Fernando Chaves-Sánchez, Ana García‐Reyne, Juan Pablo Horcajada-Gallego, C Segura, Gema Sierra-Dorado, Raquel Yano-Escudero, María Elena Dorta-Hung, Cristóbal del Rosario Q,

Antimicrobial agents and applications

The objective of this study was to analyse whether there is an association between reduced susceptibility to biocides in Acinetobacter baumannii and (i) antimicrobial resistance (co-resistance), (ii) prevalent (epidemic) clones, (iii) changes in the fitness or (iv) expression of genes related to efflux pumps and porins. 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. 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®. 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).