First report of qacG, qacH and qacJ genes in Staphylococcus haemolyticus human clinical isolates.

OBJECTIVES: To investigate phenotypically and genotypically the presence of MDR efflux pumps in 21 clinical isolates of Staphylococcus haemolyticus collected over a period of 10 years. METHODS: MICs of different antibiotics and biocides were determined by the broth dilution method in the presence/absence of carbonyl cyanide-m-chlorophenylhydrazone (CCCP), an efflux pump inhibitor. PCR followed by sequencing was performed to detect the qac genes that encode for antiseptic resistance. Clonal relationships were determined by PFGE SmaI patterns using a standard protocol. RESULTS: All the isolates were resistant to gentamicin, 15 to erythromycin, 18 to ciprofloxacin, 7 to chloramphenicol and 1 to tetracycline. They showed higher susceptibility to antibiotics when they were exposed to CCCP. The MICs of ethidium bromide, SDS and benzalkonium chloride were also decreased, whereas the MIC of triclosan was decreased in only four isolates in the presence CCCP. Of the 21 isolates, qacA/B was detected in 5 isolates, smr in all of the isolates, qacG in 11 isolates, qacH in 10 isolates and qacJ in 4 isolates. PFGE analysis of the 21 isolates clustered them into 14 clones at 90% similarity corresponding to differences of between 7 and 16 bands among the clones. CONCLUSIONS: The efflux mechanism seems to be an important mechanism to confer resistance to antibiotics and biocides through MDR pumps. It was observed that several qac genes coexist in some of the isolates and seem to act simultaneously in the removal of different compounds out of the bacterial cell. The qac genes are horizontally spread among different clones.

Multicenter study on spreading of the tet(M) gene in tetracycline-resistant Streptococcus group G and C isolates in Argentina.

A prospective multicenter study on invasive infections caused by beta-hemolytic streptococci was performed over 6 months and involved 42 centers from 16 cities in Argentina. Among 33 isolates recovered, 9 group G Streptococcus isolates (39.1%) and 2 group C Streptococcus isolates (20%) exhibited resistance to tetracycline and harbored the tet(M) gene. Genealogical analysis revealed that tetracycline resistance has a polyclonal origin in Argentina.

Survival of Acinetobacter baumannii on bed rails during an outbreak and during sporadic cases.

Genotypic methods showed Acinetobacter baumannii biotype 9 genotype I to be the epidemic strain on an outbreak in an intensive care unit (ICU) which lasted from January to April of 1996. A cohort was established during March in which hospital personnel were assigned exclusively to A. baumannii infected or colonized patients. New patients were not admitted to the ICU until the last infected patient was discharged. However, strain I was isolated during April and vectors other than human carriage were suspected. The ICU comprised four sections; patients and beds were moved within them according the severity of diseases. Strain I was isolated from a bed rail nine days after the infected patient was discharged. This dry vector may explain the transmission of the epidemic strain between sections. The following July, four new infected patients were identified and three different strains, including the epidemic one, were recovered. The two other strains were also isolated from a bed rail. Although this environmental source does not explain by itself the transmission of an epidemic strain, it illustrates that dry vectors can be secondary reservoirs where A. baumannii can survive.