Impact of Exposure of Methicillin-Resistant Staphylococcus aureus to Polyhexanide In Vitro and In Vivo

Article Article scientifique Article Impact of Exposure of Methicillin-Resistant Staphylococcus aureus to Polyhexanide In Vitro and In Vivo eng 2017 author Renzoni Adriana Maria 134435 author Von Dach Elodie 591850 Elodie Von Dach-Saouter author Landelle Caroline 767517 author Diene S M author Manzano Caroline Stéphanie 89052 author Gonzales R author Abdelhady W author Randall C P author Bonetti E J author Baud Damien 825371 author O'Neill A J author Bayer Anna-Karina 593659 author Cherkaoui Abdessalam 504646 author Schrenzel Jacques 29184 author Harbarth Stéphan Juergen 0000-0002-3551-1025 93885 author Francois Patrice 0000-0002-0540-750X 28911 e00272-17 10.1128/AAC.00272-17 28784678 0066-4804 Methicillin-resistant Staphylococcus aureus (MRSA) resistant to decolonization agents such as mupirocin and chlorhexidine increases the need for development of alternative decolonization molecules. The absence of reported severe adverse reactions and bacterial resistance to polyhexanide makes it an excellent choice as a topical antiseptic. In the present study, we evaluated the in vitro and in vivo capacity to generate strains with reduced polyhexanide susceptibility and cross-resistance with chlorhexidine and/or antibiotics currently used in clinic. Here we report the in vitro emergence of reduced susceptibility to polyhexanide by prolonged stepwise exposure to low concentrations in broth culture. Reduced susceptibility to polyhexanide was associated with genomic changes in the mprF and purR genes and with concomitant decreased susceptibility to daptomycin and other cell wall-active antibiotics. However, the in vitro emergence of reduced susceptibility to polyhexanide did not result in cross-resistance to chlorhexidine. During in vivo polyhexanide clinical decolonization treatment, neither reduced polyhexanide susceptibility nor chlorhexidine cross-resistance was observed. Together, these observations suggest that polyhexanide could be used safely for decolonization of carriers of chlorhexidine-resistant S. aureus strains; they also highlight the need for careful use of polyhexanide at low antiseptic concentrations. Dewey 616 54 Département de microbiologie et médecine moléculaire 21B 56 Département de médecine 221 false 338 Génomique et microbiote 604 526 Résistance aux antibiotiques 866 Antimicrobial Agents and Chemotherapy 61 10 fdae4f2a-4ad8-4525-be30-84c4a39e3208 Article (Published version) Restricted e00272-17.full.pdf 209538 application/pdf restrictedAccess Faculté de médecine / Section de médecine fondamentale / Département de microbiologie et médecine moléculaire Faculté de médecine / Section de médecine clinique / Département de médecine

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Impact of Exposure of Methicillin-Resistant Staphylococcus aureus to Polyhexanide In Vitro and In Vivo	Antimicrobial Agents and Chemotherapy			2017	581	1

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Bayer, Anna-Karina