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Title: Association between nasal colonisation of food handlers with quaternary ammonium compound-resistance genes harbouring staphylococcus aureus and disinfectant type
Authors: Ho, J
O'Donoghue, M 
Boost, M
Issue Date: 2013
Source: 23rd European Congress of Clinical Microbiology & Infectious Diseases, Berlin, Germany, 27-30 Apr, 2013 How to cite?
Abstract: Introduction: The intensive use of quaternary ammonium compound (QAC) based disinfectants in hospitals and the food industry has led to concern about emergence of resistant organisms. Staphylococcal resistance to these compounds is encoded by QAC genes. Investigations revealed a five-fold higher occurrence rate of qacA/B and smr) in S. aureus carriage isolates in nurses compared to the general population, but there appear to be no studies on colonization of food handlers. This study sought to determine the prevalence of QAC genes qacA/B, and smr in nasal isolates from food industry workers in Hong Kong.
Method: Nasal swabs from 434 food industry workers at 6 catering establishments were incubated overnight at 37oC in 5% salt Brain Heart Infusion broth and cultured on SA Select agar. S. aureus was confirmed by amplification of 16S-rRNA gene and presence of qacA/B and smr investigated by PCR. Disinfection type used at each establishment was determined by questionnaire. Association between type of disinfectant and QAC gene presence was determined.
Results: Three establishments used QAC-containing agents: A: Alkyl dimethyl benzyl ammonium chloride, 1.29%, Alkyl dimethyl ethyl-benzyl ammonium chloride, 1.29%; B: Alkyl dimethyl benzyl ammonium chloride 10%, Ethanol 1.9%; C: Chlorhexidine gluconate, 15%. Overall colonization rate was 22.8% (99/434) and this was not significantly different between organizations using QAC or non-QAC based disinfectants. However, presence of qacA/B (7 isolates) and smr genes (1) was restricted to isolates from workers at establishments using QAC-based sanitizers. There was a reduced risk for presence of QAC genes in operatives employed at establishments using non-QAC products (OR 0.91; 95% CI 0.847-0.976).
Conclusions: This cross-sectional study has shown that use of QAC-based disinfectants appears to select for colonization with S. aureus carrying QAC genes in food handlers at these establishments, though the overall QAC positivity rate was comparable to that of the general public. This is the first study showing a clear association between antiseptic use and carriage of antiseptic resistance genes in strains of exposed workers.
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