1887

Abstract

Four community-associated meticillin-resistant (CA-MRSA) isolates expressing high-level mupirocin resistance (MIC >1024 mg l) were isolated from four sites of a diabetic patient and characterized for the genetic location of their resistance determinants and typed using PFGE, staphylococcal cassette chromosome (SCC), the coagulase gene and multilocus sequence typing to ascertain their relatedness. The presence of genes for resistance to high-level mupirocin (), tetracycline () and fusidic acid (), Panton–Valentine leukocidin (PVL), accessory gene regulators () and capsular polysaccharide () were detected in PCR assays. The isolates were resistant to kanamycin, streptomycin, tetracycline, fusidic acid and cadmium acetate, and harboured , , , PVL, and . They had identical PFGE patterns and coagulase gene type, possessed the type IV SCC element and belonged to sequence type 80 (ST80). However, they had three different plasmid profiles: (i) 28.0 and 26.0 kb; (ii) 28.0, 21.0 and 4.0 kb; and (iii) 41.0 and 4.0 kb. Genetic studies located the resistance to tetracycline, fusidic acid and cadmium acetate on the 28 kb plasmid and on the related non-conjugative 26 and 21 kb plasmids. One of the 21 kb mupirocin-resistance plasmids was derived from the ∼41 kb plasmid during transfer experiments. The emergence of high-level mupirocin resistance in the ST80-SCC IV MRSA clone demonstrates the increasing capacity of CA-MRSA clones to acquire resistance to multiple antibacterial agents. The presence of different plasmid profiles in genetically identical isolates creates difficulty in the interpretation of typing results and highlights the weakness of using plasmid analysis as the sole method for strain typing.

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2010-02-01
2019-11-17
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References

  1. Barrett, S. P. ( 1990; ). The value of nasal mupirocin in containing an outbreak of methicillin-resistant Staphylococcus aureus in an orthopaedic unit. J Hosp Infect 15, 137–142.[CrossRef]
    [Google Scholar]
  2. BSAC ( 2005; ). BSAC Disc Diffusion Method for Antimicrobial Susceptibility Testing. Birmingham: British Society for Antimicrobial Chemotherapy. http://www.bsac.org.uk/_db/_documents/version_4_january_2005_final_NH_april_2.pdf
  3. CLSI ( 2006; ). Performance Standards for Antimicrobial Susceptibility Testing, 16th information supplement, approved standard M100-S16. Wayne, PA: Clinical and Laboratory Standards Institute.
  4. Denis, O., Deplano, A., De Beenhouwer, H., Hallin, M., Huysmans, G., Garrino, M. G., Glupczynski, Y., Malaviolle, X., Vergison, A. & Struelens, M. J. ( 2005; ). Polyclonal emergence and importation of community-acquired methicillin-resistant Staphylococcus aureus strains harbouring Panton–Valentine leucocidin genes in Belgium. J Antimicrob Chemother 56, 1103–1106.[CrossRef]
    [Google Scholar]
  5. Diep, B. A., Gill, S. R., Chang, R. F., Phan, T. H., Chen, J. H., Davidson, M. G., Lin, F., Lin, J., Carleton, H. A. & other authors ( 2006; ). Complete genome sequence of USA300, an epidemic clone of community-acquired methicillin-resistant Staphylococcus aureus. Lancet 367, 731–739.[CrossRef]
    [Google Scholar]
  6. Enright, M. C., Day, N. P. J., Davies, C. E., Peacock, S. J. & Spratt, B. G. ( 2000; ). Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 38, 1008–1015.
    [Google Scholar]
  7. Gilbart, J., Perry, C. R. & Slocombe, B. ( 1993; ). High-level mupirocin resistance in Staphylococcus aureus: evidence for two distinct isoleucyl-tRNA synthetases. Antimicrob Agents Chemother 37, 32–38.[CrossRef]
    [Google Scholar]
  8. Goh, S.-H., Byrne, S. K., Zhang, J. L. & Chow, A. W. ( 1992; ). Molecular typing of Staphylococcus aureus on the basis of coagulase gene polymorphism. J Clin Microbiol 30, 1642–1645.
    [Google Scholar]
  9. Lina, G., Piemont, Y., Godail-Gamot, F., Bes, M., Peter, M.-O., Gauduchon, V., Vandenesch, F. & Etienne, J. ( 1999; ). Involvement of Panton–Valentine leukocidin producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 29, 1128–1132.[CrossRef]
    [Google Scholar]
  10. Lina, G., Boutite, F., Tristan, A., Bes, M., Etienne, J. & Vandenesch, F. ( 2003; ). Bacterial competition for human nasal cavity colonization: role of staphylococcal agr alleles. Appl Environ Microbiol 69, 18–23.[CrossRef]
    [Google Scholar]
  11. Maltezou, H. C. & Giamarellou, H. C. ( 2006; ). Community acquired methicillin-resistant Staphylococcus aureus infection. Int J Antimicrob Agents 27, 87–96.[CrossRef]
    [Google Scholar]
  12. Moore, P. C. L. & Lindsay, J. A. ( 2001; ). Genetic variation among hospital isolates of methicillin-sensitive Staphylococcus aureus: evidence for horizontal transfer of virulence genes. J Clin Microbiol 39, 2760–2767.[CrossRef]
    [Google Scholar]
  13. Oliveira, D. C. & de Lencastre, H. ( 2002; ). Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 46, 2155–2161.[CrossRef]
    [Google Scholar]
  14. Pérez-Roth, E., López-Aguillar, C., Alcoba-Florez, J. & Méndez-Alvarez, S. ( 2006; ). High-level mupirocin resistance within methicillin-resistant Staphylococcus aureus pandemic lineages. Antimicrob Agents Chemother 50, 3207–3211.[CrossRef]
    [Google Scholar]
  15. Rahman, M., Noble, W. C. & Cookson, B. ( 1989; ). Transmissible mupirocin resistance in Staphylococcus aureus. Epidemiol Infect 102, 261–270.[CrossRef]
    [Google Scholar]
  16. Simor, A. E., Stuart, T. L., Louie, L., Watt, C., Ofner-Agostini, M., Gravel, D., Mulvey, M., Loeb, M., McGeer, A. & other authors ( 2007; ). Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian hospitals. Antimicrob Agents Chemother 51, 3880–3886.[CrossRef]
    [Google Scholar]
  17. Takizawa, Y., Tanaike, I., Nakagawa, S., Oishi, T., Nitahara, Y., Iwakura, N., Ozaki, K., Takano, M., Nakayama, T. & Yamamoto, T. ( 2005; ). A Panton–Valentine leucocidin (PVL)-positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strain, another such strain carrying a multidrug resistance plasmid, and other more-typical PVL-negative MRSA strains found in Japan. J Clin Microbiol 43, 3356–3363.[CrossRef]
    [Google Scholar]
  18. Tenover, F. C., McDougal, L. K., Goering, R. V., Killgore, G., Projan, S. J., Patel, J. B. & Dunman, P. M. ( 2006; ). Characterization of a strain of community-associated methicillin-resistant Staphylococcus aureus widely disseminated in the United States. J Clin Microbiol 44, 108–118.[CrossRef]
    [Google Scholar]
  19. Trzcinski, K., Cooper, B. S., Hryniewicz, W. & Dowson, C. G. W. ( 2000; ). Expression of resistance to tetracyclines in strains of methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 45, 763–770.[CrossRef]
    [Google Scholar]
  20. Udo, E. E. & Grubb, W. B. ( 1990; ). A new class of conjugative plasmids in Staphylococcus aureus. J Med Microbiol 31, 207–212.[CrossRef]
    [Google Scholar]
  21. Udo, E. E. & Jacob, L. E. ( 1998; ). Conjugative transfer of high-level mupirocin resistance and the mobilization of non-conjugative plasmids in Staphylococcus aureus. Microb Drug Resist 4, 185–193.[CrossRef]
    [Google Scholar]
  22. Udo, E. E., Pearman, J. W. & Grubb, W. B. ( 1994; ). Emergence of mupirocin resistance in methicillin-resistant Staphylococcus aureus in Western Australia. J Hosp Infect 26, 157–165.[CrossRef]
    [Google Scholar]
  23. Udo, E. E., Jacob, L. E. & Mathew, B. ( 2001; ). Genetic analysis of methicillin-resistant Staphylococcus aureus expressing high-and low-level mupirocin resistance. J Med Microbiol 50, 909–915.
    [Google Scholar]
  24. Udo, E. E., O'Brien, F. G., Al-Sweih, N., Noronha, B., Mathew, B. & Grubb, W. B. ( 2008; ). Genetic lineages of community-associated methicillin-resistant Staphylococcus aureus in Kuwait hospitals. J Clin Microbiol 46, 3514–3516.[CrossRef]
    [Google Scholar]
  25. Witte, W., Braulke, C., Cuny, C., Strommenge, B., Werner, G., Heuck, D., Jappe, U., Wendt, C., Linde, H. J. & Harmsen, D. ( 2005; ). Emergence of methicillin-resistant Staphylococcus aureus with Panton–Valentine leukocidin in central Europe. Eur J Clin Microbiol Infect Dis 24, 1–5.[CrossRef]
    [Google Scholar]
  26. Zhang, K., McClure, J. A., Elsayed, S., Louie, T. & Conly, J. M. ( 2005; ). Novel PCR assay for characterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus. J Clin Microbiol 43, 5026–5033.[CrossRef]
    [Google Scholar]
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