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Prevalence of antiseptic resistance genes increases in staphylococcal isolates from orthokeratology lens wearers over initial six-month period of use

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The purpose of this study was to investigate the prevalence of antiseptic-resistance (QAC) genes in staphylococci colonizing periorbital tissues and accessories of orthokeratology (ortho-k) lens wearers over a 6-month period and determine the effect of their presence on minimum inhibitory (MIC) and bactericidal concentrations (MBC) of disinfectants and log reduction of multipurpose contact lens solutions (MPS). Staphylococci were isolated from periorbital tissues and accessories of patients before commencing ortho-k therapy and at two subsequent visits. Presence of QAC genes in 116 S. aureus and 67 CNS isolates was determined by PCR and association with period of ortho-k use determined. MICs and MBCs of staphylococci gene-positive were compared with gene-negative strains and the effectiveness of four MPS for rigid contact lenses investigated. S. aureus carriage rates in the conjunctiva decreased significantly from 41.2 % (baseline) to 11.8 % (3-months), and 13.3 % (6-months) (p trend 0.03), while CNS increased from 58.8 %(baseline) to 94.1 % (3-months), and 93.3 % (6-months) (p trend 0.02). Prevalence of qacA/B increased considerably over time (S. aureus: 4.4 % to 15.4 %, CNS: 6.7 % to 25 %), but frequency of smr was relatively stable. Only five CNS isolates harboured qacH. MICs and MBCs of gene-positive isolates were significantly increased and three MPS did not achieve a 3-log reduction of many QAC-positive strains. Ortho-k lens wear contributed to changes of staphylococcal carriage rates in the conjunctival sac. Use of MPS containing quaternary ammonium compounds may select for the carriage of organisms harbouring QAC genes, as the low concentration of disinfecting agents is not adequate for killing gene-positive strains.

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Acknowledgments

Control strains were kindly provided by Prof K Hiromatsu and Prof J Bjorland. The authors are grateful to Mr Jeffrey Ho for his technical help and Ms Peggy Cheung, Ms TT Lee, Ms Cherie Chan, Mr Terry Ng, and Ms Angel Wong for their help with subject recruitment.

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Authors and Affiliations

  1. School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong

    Shi Guang-sen & Pauline Cho

  2. Squina Centre for Infection Control, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong

    Maureen Boost & Pauline Cho

Authors
  1. Shi Guang-sen
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  2. Maureen Boost
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  3. Pauline Cho
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Corresponding author

Correspondence to Maureen Boost.

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Funding

This study was supported by a Research Postgraduate Student Grant from The Hong Kong Polytechnic University to GS Shi.

Conflict of interest

The authors confirm that they have no conflicts of interest.

Ethical approval

This study followed the tenets of the Declaration of Helsinki revised in 2002 and ethics approval was obtained from the Departmental Research Committee of the School of Optometry.

Informed consent

Informed consent was obtained from a parent or guardian of each of the children enrolled in the study. The study aims and requirements were explained to the parent and risks and benefits of ortho-k treatment were discussed before admission to the study. Each parent was given an information sheet and could contact the clinic for guidance between scheduled visits. Participants were informed that they could leave the study at any time without penalty.

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Guang-sen, S., Boost, M. & Cho, P. Prevalence of antiseptic resistance genes increases in staphylococcal isolates from orthokeratology lens wearers over initial six-month period of use. Eur J Clin Microbiol Infect Dis 35, 955–962 (2016). https://doi.org/10.1007/s10096-016-2622-z

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  • DOI: https://doi.org/10.1007/s10096-016-2622-z

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