1887

Abstract

Multidrug-resistant (MDR) isolated from cystic fibrosis (CF) sputum was shown to be more tolerant to the most commonly used chlorine-based disinfecting agent in the UK, with approximately 7 out of 10 isolates surviving a residual free chlorine (RFC) concentration of 500 p.p.m., when compared with antibiotic-sensitive invasive from a non-CF blood culture source, where 8 out of 10 isolates were killed at a RFC concentration of 100 p.p.m. All CF isolates were killed at 1000 p.p.m. chlorine. Additional studies were performed to examine factors that influenced the concentration of RFC from chlorine-based (sodium dichloroisocyanurate) disinfecting agents in contact with CF sputum and their components (bacterial cells, glycocalyx) to assess the reduction of the bactericidal activity of such disinfecting agents. glycocalyx had a greater inhibitory effect of chlorine deactivation than bacterial cells. Calibration curves demonstrated the relative deactivating capacity on RFC from clinical soils, in the order pus>CF sputum>wound discharge fluid/synovial fluid>ascites fluid>bile, where quantitatively each 1 % (w/v) CF sputum reduced the RFC by 43 p.p.m. Sublethal stressing of with chlorine resulted in lowered susceptibility to colistin ( = 0.0326) but not to meropenem, tobramycin or ciprofloxacin. In conclusion, heavy contamination of healthcare fomites with CF sputum containing MDR may result in exhaustion of RFC, and this, combined with an increased resistance to chlorine with such strains, may lead to their survival and increased antibiotic resistance in such environments. CF infection prevention strategies in such scenarios should therefore target interventions with increased concentrations of chlorine to ensure the eradication of MDR from the CF healthcare environment.

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2014-09-01
2019-11-22
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References

  1. Clasen T., Edmondson P.. ( 2006;). Sodium dichloroisocyanurate (NaDCC) tablets as an alternative to sodium hypochlorite for the routine treatment of drinking water at the household level. . Int J Hyg Environ Health 209:, 173–181. [CrossRef][PubMed]
    [Google Scholar]
  2. Li X. Z., Nikaido H., Poole K.. ( 1995;). Role of MexA–MexB–OprM in antibiotic efflux in Pseudomonas aeruginosa. . Antimicrob Agents Chemother 39:, 1948–1953. [CrossRef][PubMed]
    [Google Scholar]
  3. Maeda Y., Murayama M., Goldsmith C. E., Coulter W. A., Mason C., Millar B. C., Dooley J. S., Lowery C. J., Matsuda M.. & other authors ( 2011;). Molecular characterization and phylogenetic analysis of quinolone resistance-determining regions (QRDRs) of gyrA, gyrB, parC and parE gene loci in viridans group streptococci isolated from adult patients with cystic fibrosis. . J Antimicrob Chemother 66:, 476–486. [CrossRef][PubMed]
    [Google Scholar]
  4. Marles-Wright J., Grant T., Delumeau O., van Duinen G., Firbank S. J., Lewis P. J., Murray J. W., Newman J. A., Quin M. B.. & other authors ( 2008;). Molecular architecture of the “stressosome,” a signal integration and transduction hub. . Science 322:, 92–96. [CrossRef][PubMed]
    [Google Scholar]
  5. Nagy G., Nagy L.. 2007;) Halogens.. In Handbook of Water Analysis, , 1st edn., pp. 169–194. Edited by Nollet L. M. L., De Gelder L. S. P... Baton Rouge, FL:: CRC Press;.
    [Google Scholar]
  6. Randall L. P., Bagnall M. C., Karatzas K. A., Coldham N. C., Piddock L. J., Woodward M. J.. ( 2008;). Fitness and dissemination of disinfectant-selected multiple-antibiotic-resistant (MAR) strains of Salmonella enterica serovar Typhimurium in chickens. . J Antimicrob Chemother 61:, 156–162. [CrossRef][PubMed]
    [Google Scholar]
  7. Rao P., McCaughan J., McCalmont M., Goldsmith C. E., Hall V., Millar B. C., McCann M. A., Downey D. G., Rendall J. C.. & other authors ( 2012;). Comparison of antibiotic susceptibility patterns in Pseudomonas aeruginosa isolated from adult patients with cystic fibrosis (CF) with invasive Pseudomonas aeruginosa from non-CF patients. . J Cyst Fibros 11:, 349–352. [CrossRef][PubMed]
    [Google Scholar]
  8. Tazumi A., Maeda Y., Goldsmith C. E., Coulter W. A., Mason C., Millar B. C., McCalmont M., Rendall J., Elborn J. S.. & other authors ( 2009;). . J Antimicrob Chemother 64: Molecular characterization of macrolide resistance determinants [erm(B) and mef(A)] in Streptococcus pneumoniae and viridans group streptococci (VGS) isolated from adult patients with cystic fibrosis (CF). , 501–506. [CrossRef][PubMed]
    [Google Scholar]
  9. Wholey W. Y., Jakob U.. ( 2012;). Hsp33 confers bleach resistance by protecting elongation factor Tu against oxidative degradation in Vibrio cholerae. . Mol Microbiol 83:, 981–991. [CrossRef][PubMed]
    [Google Scholar]
  10. Winter J., Ilbert M., Graf P. C., Ozcelik D., Jakob U.. ( 2008;). Bleach activates a redox-regulated chaperone by oxidative protein unfolding. . Cell 135:, 691–701. [CrossRef][PubMed]
    [Google Scholar]
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