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JAC Advance Access originally published online on March 2, 2007
Journal of Antimicrobial Chemotherapy 2007 59(5):848-853; doi:10.1093/jac/dkm031
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Triclosan resistance in methicillin-resistant Staphylococcus aureus expressed as small colony variants: a novel mode of evasion of susceptibility to antiseptics

Roger Bayston*, Waheed Ashraf and Toni Smith

Biomaterials-Related Infection Group, Division of Orthopaedic and Accident Surgery, School of Medical and Surgical Sciences, University Hospitals Nottingham, Nottingham NG7 2UH, UK

Received 3 November 2006; returned 13 December 2006; revised 22 January 2007; accepted 23 January 2007

* Correspondence address. Biomaterials-Related Infection Group, Division of Orthopaedic and Accident Surgery, School of Medical and Surgical Sciences, C Floor West Block, University Hospital QMC, Nottingham NG7 2UH, UK. Tel: +44-115-82-31115; Fax: +44-115-82-31118; E-mail: roger.bayston{at}nottingham.ac.uk

Objectives: Triclosan is in widespread use in domestic, commercial and healthcare settings and is used to reduce methicillin-resistant Staphylococcus aureus (MRSA) load in carriers. Triclosan resistance is uncommon, usually being due to mutation in fabI or overexpression of efflux pumps. This study investigated the ability of triclosan-containing silicone elastomer to kill MRSA adherent to its surface.

Methods: Silicone discs containing triclosan were prepared by a matrix-expansion method previously described. Discs were exposed to three strains of MRSA for 1 h for adhesion to take place. After incubation, discs were removed at intervals, sonicated and the sonicates analysed by chemiluminescence and viable counting. Survivors were found to consist of small colony variants (SCVs). These were then subjected to tests for known SCV characteristics and for susceptibility to triclosan.

Results: Viable counts fell until 51 h, when they began to increase, due to SCV. Of the three SCV strains, two showed impaired coagulase production and all showed reduced deoxyribonuclease production. None was auxotrophic. MICs of triclosan in the SCV rose by between 8- and 67-fold.

Conclusions: Prolonged exposure of MRSA to triclosan-impregnated silicone, as in ‘antimicrobial’ plastics or catheters, resulted in the induction of SCV status and triclosan resistance. This has implications for industrial, medical and domestic use of polymers containing triclosan. SCVs are pathogenic and persistent. The widespread use of triclosan could lead to infection with MRSA SCVs, and new antimicrobials with physiological targets similar to that of triclosan might give rise to SCV resistance in clinical use.

Keywords: SCV , MRSA , antimicrobial biomaterials


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