title: Recurrent Methicillin-Resistant Staphylococcus aureus Cutaneous Abscesses and Selection of Reduced Chlorhexidine Susceptibility during Chlorhexidine Use.
abstract: We describe the selection of reduced chlorhexidine susceptibility during chlorhexidine use in a patient with two episodes of cutaneous USA300 methicillin-resistant Staphylococcus aureus abscess. The second clinical isolate harbors a novel plasmid that encodes the QacA efflux pump. Greater use of chlorhexidine for disease prevention warrants surveillance for resistance.
authors: Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors: Ryan C
authors: RC
authors: Johnson
authors: Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors: Carey D
authors: CD
authors: Schlett
authors: Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors: Katrina
authors: K
authors: Crawford
authors: Martin Army Community Hospital, Fort Benning, Georgia, USA.
authors: Jeffrey B
authors: JB
authors: Lanier
authors: Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA douglas.merrell@usuhs.edu Michael.ellis606@gmail.com.
authors: D Scott
authors: DS
authors: Merrell
authors: Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA douglas.merrell@usuhs.edu Michael.ellis606@gmail.com.
authors: Michael W
authors: MW
authors: Ellis
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D000293:Adolescent; D001426:Bacterial Proteins / Q000235:genetics*; D002710:Chlorhexidine / Q000627:therapeutic use; D004202:Disinfectants / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins / Q000235:genetics*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008889:Military Personnel; D008969:Molecular Sequence Data; D010957:Plasmids / Q000235:genetics; D012008:Recurrence; D012641:Selection, Genetic / Q000187:drug effects / Q000235:genetics; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D011795:Surveys and Questionnaires
chemical_list: D001426:Bacterial Proteins; D004202:Disinfectants; D026901:Membrane Transport Proteins; C068498:qacA protein, Staphylococcus aureus; D002710:Chlorhexidine