Co-Selection of Antibiotic and Disinfectant Resistance in Bacteria Isolated from Reusable Blood Collection...

Background: Reusable tourniquets are widely used across clinical settings, yet their role as reservoirs of microbial contamination and antimicrobial resistance remains poorly characterized. Methods: In this cross-sectional study, 53 polyester-elastane tourniquets were collected from an Emergency Department (SR) and Operating Theater (SBO) over a 28-day period to assess bacterial burden and resistome composition. A 180-target qPCR panel targeting antibiotic and disinfectant resistance determinants was used. qPCR analysis identified 112 distinct resistance genes across all samples, with SR tourniquets harboring significantly richer resistomes than SBO (median 34 vs. 15 genes; p < 0.001). Efflux pump- and disinfectant-associated genes were pervasive, and β-lactamase and quinolone-resistance determinants increased over time in SR samples. Results: Principal component analysis showed clear segregation of resistome profiles by clinical unit and progressive enrichment over time. These findings indicate that reusable, porous tourniquets can accumulate extensive resistance gene profiles under routine clinical use, particularly in high-contact environments. Conclusions: Enhanced decontamination strategies, development of new materials or transition to single-use alternatives may be necessary to mitigate their potential contribution to environmental antimicrobial resistance in hospitals.