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Comparative Genomic Analysis Provides Insights into the Evolution and Genetic Diversity of Community-Genotype Sequence Type 72 Staphylococcus aureus Isolates. mSystems 2021; 6:e0098621. [PMID: 34491085 PMCID: PMC8547429 DOI: 10.1128/msystems.00986-21] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus aureus sequence type (ST) 72, the predominant community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) lineage in South Korea, has emerged as a major cause of bloodstream infection in hospital settings. However, relatively little information is available regarding the genomic characteristics and dissemination of ST72. Here, we characterized the whole-genome sequence of 24 ST72 isolates from China, along with 83 ST72 genomes from global sources. Of these 107 ST72 isolates, 63 were MRSA and 44 were methicillin-susceptible S. aureus (MSSA). Phylogenetic analysis revealed four distinct clades (A, B, C, and D), of which clade D contained only MSSA isolates. By characterizing the evolutionary dynamics of the ST72 lineage, we found that the MRSA from China might not have developed from the MSSA in China. Furthermore, we observed both international transmission of ST72 isolates and interregional transmission within China. The distributions of the SCCmec and spa types of isolates differed among clades. Additionally, in silico analyses revealed that the distributions of resistance genes, virulence genes, and mobile genetic elements (MGEs) also differed among isolates of the four clades. This was especially true for clade D isolates, which had the lowest level of antimicrobial resistance and had obtained specific virulence genes such as tsst-1 by acquisition of specific MGEs. Notably, ST72 MRSA isolates were more antibiotic resistant than ST72 MSSA isolates, but comparably virulent. Our findings provide insight into the potential transmission and genotypic features of ST72 clones across the globe. IMPORTANCE Understanding the evolution and dissemination of community-genotype ST72 Staphylococcus aureus isolates is important, as isolates of this lineage have rapidly spread into hospital settings and caused serious health issues. In this study, we first carried out genome-wide analysis of 107 global ST72 isolates to characterize the evolution and genetic diversity of the ST72 lineage. We found that the MSSA lineage in China might have evolved independently from the MRSA isolates from China, and that ST72 isolates have the potential to undergo both international transmission and interregional transmission within China. The diversity of isolates correlated with distinct acquisitions of SCCmec elements, antibiotic resistance genes, virulence genes, and mobile genetic elements. The comprehensive information on the ST72 lineage emerging from this study will enable improved therapeutic approaches and rapid molecular diagnosis.
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Batool N, Shamim A, Chaurasia AK, Kim KK. Genome-Wide Analysis of Staphylococcus aureus Sequence Type 72 Isolates Provides Insights Into Resistance Against Antimicrobial Agents and Virulence Potential. Front Microbiol 2021; 11:613800. [PMID: 33552024 PMCID: PMC7854921 DOI: 10.3389/fmicb.2020.613800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/17/2020] [Indexed: 12/24/2022] Open
Abstract
Staphylococcus aureus sequence type 72 (ST72) is a major community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) that has rapidly entered the hospital setting in Korea, causing mild superficial skin wounds to severe bloodstream infections. In this study, we sequenced and analyzed the genomes of one methicillin-resistant human isolate and one methicillin-sensitive human isolate of ST72 from Korea, K07-204 and K07-561, respectively. We used a subtractive genomics approach to compare these two isolates to other 27 ST72 isolates to investigate antimicrobial resistance (AMR) and virulence potential. Furthermore, we validated genotypic differences by phenotypic characteristics analysis. Comparative and subtractive genomics analysis revealed that K07-204 contains methicillin (mecA), ampicillin (blaZ), erythromycin (ermC), aminoglycoside (aadD), and tetracycline (tet38, tetracycline efflux pump) resistance genes while K07-561 has ampicillin (blaZ) and tetracycline (tet38) resistance genes. In addition to antibiotics, K07-204 was reported to show resistance to lysostaphin treatment. K07-204 also has additional virulence genes (adsA, aur, hysA, icaABCDR, lip, lukD, sdrC, and sdrE) compared to K07-561, which may explain the differential virulence potential of these human isolates of ST72. Unexpectedly, the virulence potential of K07-561 was higher in an in vivo wax-worm infection model than that of K07-204, putatively due to the presence of a 20-fold higher staphyloxanthin concentration than K07-204. Comprehensive genomic analysis of these two human isolates, with 27 ST72 isolates, and S. aureus USA300 (ST8) suggested that acquisition of both virulence and antibiotics resistance genes by ST72 isolates might have facilitated their adaptation from a community to a hospital setting where the selective pressure imposed by antibiotics selects for more resistant and virulent isolates. Taken together, the results of the current study provide insight into the genotypic and phenotypic features of various ST72 clones across the globe, delivering more options for developing therapeutics and rapid molecular diagnostic tools to detect resistant bacteria.
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Affiliation(s)
- Nayab Batool
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Amen Shamim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Akhilesh Kumar Chaurasia
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea.,Institute of Antimicrobial Resistance and Therapeutics (IAMRT), Sungkyunkwan University (SKKU), Suwon, South Korea
| | - Kyeong Kyu Kim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea.,Institute of Antimicrobial Resistance and Therapeutics (IAMRT), Sungkyunkwan University (SKKU), Suwon, South Korea.,Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Samsung Medical Center (SMC), Sungkyunkwan University School of Medicine, Seoul, South Korea
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Nakamura M, Kawada H, Uchida H, Takagi Y, Obata S, Eda R, Hanaki H, Kitasato H. Single nucleotide polymorphism leads to daptomycin resistance causing amino acid substitution-T345I in MprF of clinically isolated MRSA strains. PLoS One 2021; 16:e0245732. [PMID: 33481910 PMCID: PMC7822245 DOI: 10.1371/journal.pone.0245732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 01/06/2021] [Indexed: 12/29/2022] Open
Abstract
Daptomycin (DAP) is one of the most potent antibiotics used for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. Due to an increase in its administration for combating MRSA infections, DAP non-susceptible (DAP-NS) MRSA strains have recently been reported in clinical settings. The presence of single nucleotide polymorphisms (SNPs) in the multiple peptide resistance factor (mprF) gene is the most frequently reported cause for the evolution of DAP-NS MRSA strains; however, there are some variations of SNPs that could lead to DAP-NS. In this study, we used two clinical MRSA strains, including DAP susceptible (DAP-S) and DAP-NS, isolated from the same patient at different time points. We introduced T345I SNP to mprF of the DAP-S MRSA strain using the gene exchange method with pIMAY vector. Further, we investigated the phenotype of the mutant strain, including drug susceptibility, cell surface positive charge, and growth speed. The mutant strain exhibited (i) resistance to DAP, (ii) up-regulation of positive surface charge, (iii) slower growth speed, and (iv) thickened cell walls. Hence, the SNP in mprF may have caused an up-regulation in MprF function, with a subsequent increase in positive surface charge. Cumulatively, these results demonstrated that the T345I amino acid substitution in mprF represents one of the primary causes of DAP-NS in MRSA strains.
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Affiliation(s)
- Masaki Nakamura
- Department of Microbiology, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
- Department of Environmental Microbiology, Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan
- Research Center for Infection control, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
- * E-mail:
| | - Hayato Kawada
- Department of Environmental Microbiology, Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan
| | - Hiroki Uchida
- Department of Microbiology, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - Yusuke Takagi
- Department of Microbiology, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - Shuichi Obata
- Department of Anatomical Sciences, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
- Department of Histology and Cell Biology, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Ryotaro Eda
- Department of Environmental Microbiology, Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan
| | - Hideaki Hanaki
- Research Center for Infection control, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Hidero Kitasato
- Department of Microbiology, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
- Department of Environmental Microbiology, Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan
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4
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Imipenem plus Fosfomycin as Salvage Therapy for Vertebral Osteomyelitis. Antimicrob Agents Chemother 2020; 65:AAC.01746-20. [PMID: 32958715 DOI: 10.1128/aac.01746-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/12/2020] [Indexed: 01/24/2023] Open
Abstract
We applied combination antibiotic therapy to treat vertebral osteomyelitis and a psoas abscess caused by glycopeptide-intermediate (MIC, 2 μg/ml) and daptomycin-nonsusceptible (>2 μg/ml) methicillin-resistant Staphylococcus aureus The Etest synergy test showed the largest synergistic effects for imipenem/cilastatin and fosfomycin. Whole-gene sequencing showed amino acid changes in SA0802, SA1193 (mprF), and SA1531 (ald). Four weeks of combination treatment using imipenem/cilastatin (1.5 g per day) and fosfomycin (4.0 g per day) resulted in clinical improvement.
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5
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Sakurada M, Sumi H, Kaji K, Kobayashi N, Sakai Y, Aung MS, Urushibara N, Kobayashi N. Pacemaker-associated infection caused by ST81/SCC mec IV methicillin-resistant, vancomycin-intermediate Staphylococcus aureus in Japan. New Microbes New Infect 2020; 35:100656. [PMID: 32215211 PMCID: PMC7083773 DOI: 10.1016/j.nmni.2020.100656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 12/20/2022] Open
Abstract
A 76-year-old Japanese man was admitted to hospital for treatment of fever and skin lesion at the implantation site of his pacemaker. During his hospitalization, vancomycin-intermediate Staphylococcus aureus (MIC 4 μg/mL) with reduced susceptibility to daptomycin was isolated from venous blood. This isolate was identified as methicillin-resistant S. aureus with SCCmec IV and was genotyped as sequence type 81, coa VIIa and spa type t7044, harbouring blaZ, aac(6′)-aph(2″) and enterotoxin(-like) genes sea, seb, sek, sel, selx and selw. The patient was successfully treated with daptomycin, minocycline and sulfamethoxazole/trimethoprim. We describe the identification of sequence type 81/SCCmec IV vancomycin-intermediate S. aureus from pacemaker-associated septicaemia.
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Affiliation(s)
- M Sakurada
- Department of Pharmacy, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - H Sumi
- Department of Pharmacy, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - K Kaji
- Department of Pharmacy, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - N Kobayashi
- Department of Laboratory, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Y Sakai
- Department of Paediatrics, Hakodate Municipal Hospital, Hakodate, Japan
| | - M S Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - N Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - N Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
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6
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Aung MS, Urushibara N, Kawaguchiya M, Sumi A, Shinagawa M, Takahashi S, Kobayashi N. Clonal Diversity and Genetic Characteristics of Methicillin-ResistantStaphylococcus aureusIsolates from a Tertiary Care Hospital in Japan. Microb Drug Resist 2019; 25:1164-1175. [DOI: 10.1089/mdr.2018.0468] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriko Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mitsuyo Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ayako Sumi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masaaki Shinagawa
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
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7
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Kanesaka I, Fujisaki S, Aiba Y, Watanabe S, Mikawa T, Katsuse AK, Takahashi H, Cui L, Kobayashi I. Characterization of compensatory mutations associated with restoration of daptomycin-susceptibility in daptomycin non-susceptible methicillin-resistant Staphylococcus aureus and the role mprF mutations. J Infect Chemother 2018; 25:1-5. [PMID: 30322736 DOI: 10.1016/j.jiac.2018.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/26/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
The objective of this study was to investigate the underlying mechanism explaining reversion of clinical DAP non-susceptible (NS) MRSA isolates to DAP-susceptible (S) by analysis of genomic and cell wall characteristics of clinical DAP-NS MRSA and DAP-S MRSA isolates as well as in vitro revertant DAP-S MRSA using whole genome sequencing (WGS) and analysis of biological properties. WGS of the 4 clinical DAP-NS MRSA revealed mprF mutations resulting in amino acid substitutions or deletion. These same amino acid substitutions and deletion were also observed in the 4 in vitro revertant DAP-S strains. While WGS identified the presence of the same mprF mutations in both the DAP-NS and in vitro DAP-S revertant strains, new mutations were also detected in other genes and intergenic regions of in vitro DAP-S revertant strains. Transmission electron microscopy to assess cell-wall (CW) thickness of 4 sets strains (pre- and post-DAP therapy isolates and in vitro DAP-S revertant) showed that 3 of the 4 isolates developed increased thickness of the CW after DAP therapy. After reversion to DAP susceptibility, CW thickness was decreased to the same level as DAP-S MRSA. Our results indicate that in vitro conversion of DAP-NS MRSA to DAP-S is independent of mprF gene mutations and may be partially explained by a change in CW thickness. However, as some strains showed no change in the CW, further studies are required to elucidate the different mechanisms of resistance to DAP, and factors for conversion of DAP-NS to DAP-S.
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Affiliation(s)
- Izumo Kanesaka
- Department of Biomolecular Science, Graduate School of Science, Toho University, 2-2-1, Miyama, Funabashi-shi, Chiba, 274-8510, Japan; Department of Infection Control and Prevention, Faculty of Nursing, Toho University, 4-16-20, Omori-nishi, Ota-ku, Tokyo, 143-0015, Japan
| | - Shingo Fujisaki
- Department of Biomolecular Science, Graduate School of Science, Toho University, 2-2-1, Miyama, Funabashi-shi, Chiba, 274-8510, Japan
| | - Yoshifumi Aiba
- Division of Bacteriology, Department of Infection and Immunity, School of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-Shi, Tochigi, 329-0498, Japan
| | - Shinya Watanabe
- Division of Bacteriology, Department of Infection and Immunity, School of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-Shi, Tochigi, 329-0498, Japan
| | - Takashi Mikawa
- Department of Infection Control and Prevention, Faculty of Nursing, Toho University, 4-16-20, Omori-nishi, Ota-ku, Tokyo, 143-0015, Japan
| | - Akiko Kanayama Katsuse
- Department of Infection Control and Prevention, Faculty of Nursing, Toho University, 4-16-20, Omori-nishi, Ota-ku, Tokyo, 143-0015, Japan
| | - Hiroshi Takahashi
- Department of Infection Control and Prevention, Faculty of Nursing, Toho University, 4-16-20, Omori-nishi, Ota-ku, Tokyo, 143-0015, Japan
| | - Longzhu Cui
- Division of Bacteriology, Department of Infection and Immunity, School of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-Shi, Tochigi, 329-0498, Japan
| | - Intetsu Kobayashi
- Department of Infection Control and Prevention, Faculty of Nursing, Toho University, 4-16-20, Omori-nishi, Ota-ku, Tokyo, 143-0015, Japan.
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Lee GY, Kang KM, Back SH, Baek JY, Kim SH, Park JH, Yang SJ. Adaptations of Vancomycin-Intermediate Sequence Type 72 Methicillin-Resistant Staphylococcus aureus for Daptomycin Nonsusceptibility. Microb Drug Resist 2018; 24:1489-1496. [PMID: 29927700 DOI: 10.1089/mdr.2018.0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In Korea, the major clonal type of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is sequence type 72 (ST72) with staphylococcal cassette chromosome mec (SCCmec) type IV (ST72-MRSA-IV). In this study, we used a previously well-characterized isogenic pair of ST72 vancomycin (VAN) susceptible-and VAN intermediate-MRSA strains (VSSA303 and VISA072) and several VSSA strains complemented with plasmids expressing single-point mutated genes (dprAG196C, femAF92C, vraRE127K, and vraSRE127K) identified in the VISA strain. Using the strain set, we assessed the (1) susceptibilities to daptomycin (DAP) and cationic antimicrobial peptides (CAMPs), (2) alterations in cell envelope phenotypes, such as cell wall autolysis, surface positive charge, and membrane potential (ΔΨ), (3) transcriptional expression profiles of genes involved in surface charge regulation and changes of ΔΨ, and (4) cytokine stimulation profiles in murine macrophages. The vraRE127K mutation could enhance surface positive charge through mprF- and dltABCD-independent mechanisms with thickened cell wall. However, none of the single-point mutated genes increased DAP resistance. The DAP nonsusceptible (DAP-NS) phenotype observed in VISA072 strain likely resulted from the combined effects of low ΔΨ and increased positive surface charge. These results suggest that physicochemical alterations in cell envelope are involved in the survival response of DAP-NS VISA072 in sites of infections.
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Affiliation(s)
- Gi Yong Lee
- 1 School of Bioresources and Bioscience, Chung-Ang University , Anseong, Korea
| | - Kyung Mi Kang
- 1 School of Bioresources and Bioscience, Chung-Ang University , Anseong, Korea
| | - Seung Hyun Back
- 1 School of Bioresources and Bioscience, Chung-Ang University , Anseong, Korea
| | - Jin Yang Baek
- 2 Asia Pacific Foundation for Infectious Diseases (APFID) , Seoul, Korea
- 3 Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - So Hyun Kim
- 2 Asia Pacific Foundation for Infectious Diseases (APFID) , Seoul, Korea
- 3 Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Jong-Hwan Park
- 4 Laboratory Animal Medicine, College of Veterinary Medicine, Chonnam National University , Gwangju, Korea
| | - Soo-Jin Yang
- 1 School of Bioresources and Bioscience, Chung-Ang University , Anseong, Korea
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Baek JY, Chung DR, Ko KS, Kim SH, Yang SJ, Kang CI, Peck KR, Song JH. Genetic alterations responsible for reduced susceptibility to vancomycin in community-associated MRSA strains of ST72. J Antimicrob Chemother 2018; 72:2454-2460. [PMID: 28595277 DOI: 10.1093/jac/dkx175] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/10/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives We previously reported the first case of vancomycin treatment failure due to development of vancomycin-intermediate resistance in a patient with an MRSA of ST72, a community genotype in Korea. We investigated two isogenic MRSA strains from this patient, who experienced treatment failure with vancomycin and rifampicin. Methods We tracked the genetic alterations that confer reduced susceptibility to vancomycin on those two isogenic MRSA strains by WGS. Results Five non-synonymous mutations were identified, including rpoB (H481Y), dprA (G196C), femA (F92C), vraR (E127K) and agrC (E391stop). We further studied the role of a mutation of vraR in reduced susceptibility to vancomycin. Introduction of the mutated vraR (E127K) into a vancomycin-susceptible Staphylococcus aureus strain resulted in an increase in vraSR mRNA expression and vancomycin MIC and development of the hetero-VISA phenotype, which was confirmed by the population analysis profile (PAP)/AUC. Electron microscopy showed increased cell wall thickness in the strains with mutated vraR. Conclusions Based on the genomic data, molecular experiments and PAP and cell wall analyses, we propose that a single mutation of vraR is associated with the reduced susceptibility to vancomycin in MRSA and further treatment failure.
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Affiliation(s)
- Jin Yang Baek
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea
| | - Doo Ryeon Chung
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea.,Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kwan Soo Ko
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea.,Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - So Hyun Kim
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea.,Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo-Jin Yang
- School of Bioresources and Bioscience, Chung-Ang University, Anseong, Republic of Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hoon Song
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea.,Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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10
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Stefani S, Campanile F, Santagati M, Mezzatesta ML, Cafiso V, Pacini G. Insights and clinical perspectives of daptomycin resistance in Staphylococcus aureus: A review of the available evidence. Int J Antimicrob Agents 2015; 46:278-89. [DOI: 10.1016/j.ijantimicag.2015.05.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 05/13/2015] [Indexed: 02/04/2023]
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Khatib R, Sharma M, Johnson LB, Riederer K, Shemes S, Szpunar S. Decreasing prevalence of isolates with vancomycin heteroresistance and vancomycin minimum inhibitory concentrations ≥2 mg/L in methicillin-resistant Staphylococcus aureus over 11 years: potential impact of vancomycin treatment guidelines. Diagn Microbiol Infect Dis 2015; 82:245-8. [PMID: 25935628 DOI: 10.1016/j.diagmicrobio.2015.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 10/23/2022]
Abstract
We evaluated vancomycin MIC (V-MIC) and the prevalence of intermediately susceptible (VISA) and heteroresistant (hVISA) isolates trends in methicillin-resistant Staphylococcus aureus bacteremia among 720 adults (≥ 18 years) inpatients over 4 study periods (2002-2003, 2005-2006, 2008-2009, and 2010-2012). V-MIC (Etest) and the prevalence of hVISA and VISA (determined by population analysis profile-area under the curve) were stratified according to the study period. Mean vancomycin MIC was 1.78 ± 0.39, 1.81 ± 0.47, 1.68 ± 0.26, and 1.54 ± 0.28 mg/L in 2002-2003, 2005-2006, 2008-2009, and 2010-2012, respectively (P < 0.0001). We noted a steadily decreasing prevalence of isolates with V-MIC ≥ 2 mg/L (50.0%, 45.2%, 35.4%, and 18.7%; P < 0.0001) and hVISA (9.7%, 6.6%, 3.0%, and 2.1%; P=0.0003). VISA prevalence remained low (0-2%). These changes coincided with steadily increasing vancomycin trough levels (9.9 ± 7.8, 11.1 ± 8.4, 16.6 ± 7.8, and 19.7 ± 5.9 mg/L in 2002-2003, 2005-2006, 2008-2009, and 2010-2012, respectively; P < 0.0001). These changes imply that adherence to vancomycin treatment guidelines may suppress the development of less susceptible isolates.
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Affiliation(s)
- Riad Khatib
- Department of Medicine, St John Hospital & Medical Center, Detroit, MI, USA.
| | - Mamta Sharma
- Department of Medicine, St John Hospital & Medical Center, Detroit, MI, USA
| | - Leonard B Johnson
- Department of Medicine, St John Hospital & Medical Center, Detroit, MI, USA
| | - Kathleen Riederer
- Department of Medicine, St John Hospital & Medical Center, Detroit, MI, USA
| | - Stephen Shemes
- Department of Medicine, St John Hospital & Medical Center, Detroit, MI, USA
| | - Susan Szpunar
- Department of Medicine, St John Hospital & Medical Center, Detroit, MI, USA
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12
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Evolution and single-nucleotide polymorphisms in methicillin-resistant Staphylococcus aureus strains with reduced susceptibility to vancomycin and daptomycin, based on determination of the complete genome. Antimicrob Agents Chemother 2015; 59:3585-7. [PMID: 25779584 DOI: 10.1128/aac.05159-14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 03/11/2015] [Indexed: 11/20/2022] Open
Abstract
We obtained a series of methicillin-resistant Staphylococcus aureus isolates, including both daptomycin-susceptible strain TD1 and daptomycin-resistant strain TD4, from a patient. We determined the complete genome sequences of TD1 and TD4 using next-generation sequencing, and only four single-nucleotide polymorphisms (SNPs) were identified, one each in capB (E58K), rpoB (H481Y), lytN (I16V), and mprF (V351E). We determined that these four SNPs were sufficient to cause the strains to develop daptomycin, vancomycin, and rifampin resistance.
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