ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Hala Badawi1, Alaa Reda2, Manal El Said1,3 , Amira El-Far4, Reham Magdy1, Ahmed El-Shenawy4 and Noha Yousry4
1Department of Microbiology & Infection Prevention & Control Unit, Theodor Bilharz Research Institute (TBRI), Giza 12411, Egypt.
2Department of Microbiology & Immunology, Faculty of Medicine, Cairo University, Egypt.
3Department of Microbiology, Medicine Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia.
4Department of Microbiology, Theodor Bilharz Research Institute, (TBRI), Egypt.
Article Number: 7764 | © The Author(s). 2022
J Pure Appl Microbiol. 2022;16(4):2619-2630.
Received: 14 April 2022 | Accepted: 27 September 2022 | Published online: 01 November 2022
Issue online: December 2022

The coronavirus disease (COVID-19) pandemic has expanded the use of chlorhexidine digluconate, a biocide frequently used in hospitals, to inhibit the spread of infection. Genes responsible for resistance against the quaternary ammonium compound qac in Staphylococcus aureus isolates have been shown to confer tolerance to a number of biocidal chemicals, including chlorhexidine. The aim of this study was to determine the occurrence of antiseptic resistance genes (qacA/B and qacC) in clinical isolates of methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA). The study also aimed to investigate the association between the presence of the mecA, qacA/B, and qacC genes in MRSA isolates and the susceptibility of the isolates to chlorhexidine to evaluate its future use in the Theodor Bilharz Research Institute (TBRI) hospital, following the Centers for Disease Control and Prevention recommendations for patients with MRSA. S. aureus isolates (n = 100) were collected from inpatients and outpatients at TBRI. A minimal inhibitory concentration of chlorhexidine was also detected. Polymerase chain reaction was used to detect the mecA, qacA/B, and qacC genes. The results revealed that 84% of S. aureus isolates were MRSA. MRSA (61.9%) and MSSA (68.8%) isolates were susceptible to chlorhexidine. The qacA/B gene was more dominant, being detected in 34%, while qacC was detected in only 5% of S. aureus isolates. All S. aureus isolates with reduced susceptibility to chlorhexidine harbored either the qacA/B or qacC genes. The clinical use of chlorhexidine may continue to increase, emphasizing the significance of continuous caution underlining the emergence of new clones with reduced susceptibility and avoiding antiseptic misuse.


Staphylococcus aureus, MRSA, MSSA, Chlorhexidine, qacA/B ,qacC genes, Antiseptic Resistance

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© The Author(s) 2022. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.