title: Efflux pump induction by quaternary ammonium compounds and fluoroquinolone resistance in bacteria.
abstract: Biocides, primarily those containing quaternary ammonium compounds (QAC), are heavily used in hospital environments and various industries (e.g., food, water, cosmetic). To date, little attention has been paid to potential implications of QAC use in the emergence of antibiotic resistance, especially fluoroquinolone-resistant bacteria in patients and in the environment. QAC-induced overexpression of efflux pumps can lead to: cross resistance with fluoroquinolones mediated by multidrug efflux pumps; stress response facilitating mutation in the Quinolone Resistance Determining Region; and biofilm formation increasing the risk of transfer of mobile genetic elements carrying fluoroquinolone or QAC resistance determinants. By following the European Biocidal Product Regulation, manufacturers of QAC are required to ensure that their QAC-based biocidal products are safe and will not contribute to emerging bacterial resistance.
authors.affiliation: Pôle Biologie, Teaching Hospital Pontchaillou, 35043 Rennes, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Buffet-Bataillon
authors.affiliation: Service des Maladies Infectieuses, Pontchaillou, 35043 Rennes, France.|INSERM U835, Université de Rennes 1, 35000 Rennes, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tattevin
authors.affiliation: Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Maillard
authors.affiliation: EA 1254 Microbiologie, Université de Rennes 1, 35000 Rennes, France.|Pôle Odontologie, Teaching Hospital, 35043 Rennes, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Bonnaure-Mallet
authors.affiliation: Pôle Biologie, Teaching Hospital Pontchaillou, 35043 Rennes, France.|EA 1254 Microbiologie, Université de Rennes 1, 35000 Rennes, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Jolivet-Gougeon
mesh_terms: D001419:Bacteria / Q000187:drug effects*; D018441:Biofilms / Q000254:growth & development; D001693:Biological Transport, Active / Q000187:drug effects; D004202:Disinfectants / Q000378:metabolism*; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000378:metabolism*; D026901:Membrane Transport Proteins / Q000378:metabolism*; D000644:Quaternary Ammonium Compounds / Q000378:metabolism*; D013312:Stress, Physiological / Q000187:drug effects; D015533:Transcriptional Activation / Q000187:drug effects*
chemical_list: D004202:Disinfectants; D024841:Fluoroquinolones; D026901:Membrane Transport Proteins; D000644:Quaternary Ammonium Compounds
keywords: QAC; antibiotic resistance; efflux pump; fluoroquinolone; integron; multidrug resistance; quaternary ammonium compounds