1887

Abstract

Reduced vancomycin susceptibility in can cause serious problems relating to treatment failure and persistent infection. We investigated vancomycin susceptibility, genetic relationships and transcriptional changes of the accessory gene regulator () in vancomycin-intermediate (VISA) strains isolated from South Korea compared with vancomycin-susceptible (VSSA) strains. Molecular characterization, population analysis profiling, sequencing and transcriptional profiling of RNAIII by real-time RT-PCR were performed. Of 16 VISA strains tested, eight exhibited ST5, II and type II SCC. The others exhibited ST239, I and type III SCC. A point mutation in AgrA (Asp8Gly or Ile238Lys) was found in only five VISA strains; no mutations were detected in the other strains. However, RNAIII levels markedly decreased in all VISA strains (mean of 1.39-fold change) compared with the VSSA strains (31.51-fold change) in late-exponential phases (<0.0001). The downregulation of RNAIII could be an important genetic event in the VISA strains, regardless of the presence or absence of the mutation.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.035204-0
2012-03-01
2019-10-23
Loading full text...

Full text loading...

/deliver/fulltext/jmm/61/3/345.html?itemId=/content/journal/jmm/10.1099/jmm.0.035204-0&mimeType=html&fmt=ahah

References

  1. Aires-de-Sousa M. , Boye K. , de Lencastre H. , Deplano A. , Enright M. C. , Etienne J. , Friedrich A. , Harmsen D. , Holmes A. . & other authors ( 2006; ). High interlaboratory reproducibility of DNA sequence-based typing of bacteria in a multicenter study. . J Clin Microbiol 44:, 619–621. [CrossRef] [PubMed]
    [Google Scholar]
  2. Archer G. L. . ( 1998; ). Staphylococcus aureus: a well-armed pathogen. . Clin Infect Dis 26:, 1179–1181. [CrossRef] [PubMed]
    [Google Scholar]
  3. Berger-Bächi B. , Strässle A. , Kayser F. H. . ( 1986; ). Characterization of an isogenic set of methicillin-resistant and susceptible mutants of Staphylococcus aureus . . Eur J Clin Microbiol 5:, 697–701. [CrossRef] [PubMed]
    [Google Scholar]
  4. Chambers H. F. . ( 2001; ). The changing epidemiology of Staphylococcus aureus?. Emerg Infect Dis 7:, 178–182. [CrossRef] [PubMed]
    [Google Scholar]
  5. Chung G. , Cha J. , Han S. , Jang H. , Lee K. , Yoo J. , Yoo J. , Kim H. , Eun S. . & other authors ( 2010; ). Nationwide surveillance study of vancomycin intermediate Staphylococcus aureus strains in Korean hospitals from 2001 to 2006. . J Microbiol Biotechnol 20:, 637–642.[PubMed]
    [Google Scholar]
  6. CLSI ( 2010; ). Performance standards for antimicrobial susceptibility testing. Sixteenth informational supplement. Approved standard M100–S16. . Wayne, PA:: Clinical and Laboratory Standards Institute;.
  7. Cui L. , Ma X. , Sato K. , Okuma K. , Tenover F. C. , Mamizuka E. M. , Gemmell C. G. , Kim M. N. , Ploy M. C. . & other authors ( 2003; ). Cell wall thickening is a common feature of vancomycin resistance in Staphylococcus aureus . . J Clin Microbiol 41:, 5–14. [CrossRef] [PubMed]
    [Google Scholar]
  8. Cui L. , Neoh H. M. , Shoji M. , Hiramatsu K. . ( 2009; ). Contribution of vraSR and graSR point mutations to vancomycin resistance in vancomycin-intermediate Staphylococcus aureus . . Antimicrob Agents Chemother 53:, 1231–1234. [CrossRef] [PubMed]
    [Google Scholar]
  9. Cui L. , Isii T. , Fukuda M. , Ochiai T. , Neoh H. M. , Camargo I. L. , Watanabe Y. , Shoji M. , Hishinuma T. , Hiramatsu K. . ( 2010; ). An RpoB mutation confers dual heteroresistance to daptomycin and vancomycin in Staphylococcus aureus . . Antimicrob Agents Chemother 54:, 5222–5233. [CrossRef] [PubMed]
    [Google Scholar]
  10. Enright M. C. , Day N. P. , 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.[PubMed]
    [Google Scholar]
  11. Fowler V. G. Jr , Sakoulas G. , McIntyre L. M. , Meka V. G. , Arbeit R. D. , Cabell C. H. , Stryjewski M. E. , Eliopoulos G. M. , Reller L. B. . & other authors ( 2004; ). Persistent bacteremia due to methicillin-resistant Staphylococcus aureus infection is associated with agr dysfunction and low-level in vitro resistance to thrombin-induced platelet microbicidal protein. . J Infect Dis 190:, 1140–1149. [CrossRef] [PubMed]
    [Google Scholar]
  12. Hiramatsu K. , Aritaka N. , Hanaki H. , Kawasaki S. , Hosoda Y. , Hori S. , Fukuchi Y. , Kobayashi I. . ( 1997a; ). Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. . Lancet 350:, 1670–1673. [CrossRef] [PubMed]
    [Google Scholar]
  13. Hiramatsu K. , Hanaki H. , Ino T. , Yabuta K. , Oguri T. , Tenover F. C. . ( 1997b; ). Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. . J Antimicrob Chemother 40:, 135–136. [CrossRef] [PubMed]
    [Google Scholar]
  14. Hiramatsu K. , Okuma K. , Ma X. X. , Yamamoto M. , Hori S. , Kapi M. . ( 2002; ). New trends in Staphylococcus aureus infections: glycopeptide resistance in hospital and methicillin resistance in the community. . Curr Opin Infect Dis 15:, 407–413. [CrossRef] [PubMed]
    [Google Scholar]
  15. Howden B. P. , Ward P. B. , Charles P. G. , Korman T. M. , Fuller A. , du Cros P. , Grabsch E. A. , Roberts S. A. , Robson J. . & other authors ( 2004; ). Treatment outcomes for serious infections caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility. . Clin Infect Dis 38:, 521–528. [CrossRef] [PubMed]
    [Google Scholar]
  16. Howden B. P. , Ward P. B. , Johnson P. D. , Charles P. G. , Grayson M. L. . ( 2005; ). Low-level vancomycin resistance in Staphylococcus aureus–an Australian perspective. . Eur J Clin Microbiol Infect Dis 24:, 100–108. [CrossRef] [PubMed]
    [Google Scholar]
  17. Howden B. P. , Johnson P. D. , Ward P. B. , Stinear T. P. , Davies J. K. . ( 2006; ). Isolates with low-level vancomycin resistance associated with persistent methicillin-resistant Staphylococcus aureus bacteremia. . Antimicrob Agents Chemother 50:, 3039–3047. [CrossRef] [PubMed]
    [Google Scholar]
  18. Howden B. P. , Smith D. J. , Mansell A. , Johnson P. D. , Ward P. B. , Stinear T. P. , Davies J. K. . ( 2008; ). Different bacterial gene expression patterns and attenuated host immune responses are associated with the evolution of low-level vancomycin resistance during persistent methicillin-resistant Staphylococcus aureus bacteraemia. . BMC Microbiol 8:, 39. [CrossRef] [PubMed]
    [Google Scholar]
  19. Howe R. A. , Monk A. , Wootton M. , Walsh T. R. , Enright M. C. . ( 2004; ). Vancomycin susceptibility within methicillin-resistant Staphylococcus aureus lineages. . Emerg Infect Dis 10:, 855–857.[PubMed] [CrossRef]
    [Google Scholar]
  20. Ji G. , Beavis R. C. , Novick R. P. . ( 1995; ). Cell density control of staphylococcal virulence mediated by an octapeptide pheromone. . Proc Natl Acad Sci U S A 92:, 12055–12059. [CrossRef] [PubMed]
    [Google Scholar]
  21. Ji G. , Beavis R. , Novick R. P. . ( 1997; ). Bacterial interference caused by autoinducing peptide variants. . Science 276:, 2027–2030. [CrossRef] [PubMed]
    [Google Scholar]
  22. Kim E. S. , Song J. S. , Lee H. J. , Choe P. G. , Park K. H. , Cho J. H. , Park W. B. , Kim S. H. , Bang J. H. . & other authors ( 2007; ). A survey of community-associated methicillin-resistant Staphylococcus aureus in Korea. . J Antimicrob Chemother 60:, 1108–1114. [CrossRef] [PubMed]
    [Google Scholar]
  23. Kuroda M. , Kuwahara-Arai K. , Hiramatsu K. . ( 2000; ). Identification of the up- and down-regulated genes in vancomycin-resistant Staphylococcus aureus strains Mu3 and Mu50 by cDNA differential hybridization method. . Biochem Biophys Res Commun 269:, 485–490. [CrossRef] [PubMed]
    [Google Scholar]
  24. Larkin M. A. , Blackshields G. , Brown N. P. , Chenna R. , McGettigan P. A. , McWilliam H. , Valentin F. , Wallace I. M. , Wilm A. . & other authors ( 2007; ). Clustal W2 and clustal_x version 2. . Bioinformatics 23:, 2947–2948. [CrossRef] [PubMed]
    [Google Scholar]
  25. Lee D. , Park C. , Shin H. , Choi S. , Park S. , Choi J. , Yoo J. , Shin W. . ( 2008; ). Molecular characteristics and their relationship with antibiotic resistance on methicillin resistant Staphylococcus aureus (MRSA) isolates in south Korea.. 48th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)/46th Infectious Disease Society of America (IDSA) Annual Meeting. Washington DC Oct 25–28, C2–216, 152–153.
    [Google Scholar]
  26. McAleese F. , Wu S. W. , Sieradzki K. , Dunman P. , Murphy E. , Projan S. , Tomasz A. . ( 2006; ). Overexpression of genes of the cell wall stimulon in clinical isolates of Staphylococcus aureus exhibiting vancomycin-intermediate- S. aureus-type resistance to vancomycin. . J Bacteriol 188:, 1120–1133. [CrossRef] [PubMed]
    [Google Scholar]
  27. Murchan S. , Kaufmann M. E. , Deplano A. , de Ryck R. , Struelens M. , Zinn C. E. , Fussing V. , Salmenlinna S. , Vuopio-Varkila J. . & other authors ( 2003; ). Harmonization of pulsed-field gel electrophoresis protocols for epidemiological typing of strains of methicillin-resistant Staphylococcus aureus: a single approach developed by consensus in 10 European laboratories and its application for tracing the spread of related strains. . J Clin Microbiol 41:, 1574–1585. [CrossRef] [PubMed]
    [Google Scholar]
  28. Mwangi M. M. , Wu S. W. , Zhou Y. , Sieradzki K. , de Lencastre H. , Richardson P. , Bruce D. , Rubin E. , Myers E. . & other authors ( 2007; ). Tracking the in vivo evolution of multidrug resistance in Staphylococcus aureus by whole-genome sequencing. . Proc Natl Acad Sci U S A 104:, 9451–9456. [CrossRef] [PubMed]
    [Google Scholar]
  29. 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] [PubMed]
    [Google Scholar]
  30. Papakyriacou H. , Vaz D. , Simor A. , Louie M. , McGavin M. J. . ( 2000; ). Molecular analysis of the accessory gene regulator (agr) locus and balance of virulence factor expression in epidemic methicillin-resistant Staphylococcus aureus . . J Infect Dis 181:, 990–1000. [CrossRef] [PubMed]
    [Google Scholar]
  31. Park C. , Lee D. G. , Kim S. W. , Choi S. M. , Park S. H. , Chun H. S. , Choi J. H. , Yoo J. H. , Shin W. S. . & other authors ( 2007; ). Predominance of community-associated methicillin-resistant Staphylococcus aureus strains carrying staphylococcal chromosome cassette mec type IVA in South Korea. . J Clin Microbiol 45:, 4021–4026. [CrossRef] [PubMed]
    [Google Scholar]
  32. Park C. , Lee D. G. , Choi S. M. , Choi J. H. , Park S. H. , Yoo J. H. , Shin W. S. . ( 2008; ). Comment on: a survey of community-associated methicillin-resistant Staphylococcus aureus in Korea. . J Antimicrob Chemother 62:, 211–212. [CrossRef] [PubMed]
    [Google Scholar]
  33. Park C. , Shin H. H. , Kwon E. Y. , Choi S. M. , Kim S. H. , Park S. H. , Choi J. H. , Yoo J. H. , Lee D. G. , Shin W. S. . ( 2009; ). Two variants of staphylococcal cassette chromosome mec type IVA in community-associated methicillin-resistant Staphylococcus aureus strains in South Korea. . J Med Microbiol 58:, 1314–1321. [CrossRef] [PubMed]
    [Google Scholar]
  34. Pfeltz R. F. , Singh V. K. , Schmidt J. L. , Batten M. A. , Baranyk C. S. , Nadakavukaren M. J. , Jayaswal R. K. , Wilkinson B. J. . ( 2000; ). Characterization of passage-selected vancomycin-resistant Staphylococcus aureus strains of diverse parental backgrounds. . Antimicrob Agents Chemother 44:, 294–303. [CrossRef] [PubMed]
    [Google Scholar]
  35. Reipert A. , Ehlert K. , Kast T. , Bierbaum G. . ( 2003; ). Morphological and genetic differences in two isogenic Staphylococcus aureus strains with decreased susceptibilities to vancomycin. . Antimicrob Agents Chemother 47:, 568–576. [CrossRef] [PubMed]
    [Google Scholar]
  36. Renzoni A. , Francois P. , Li D. , Kelley W. L. , Lew D. P. , Vaudaux P. , Schrenzel J. . ( 2004; ). Modulation of fibronectin adhesins and other virulence factors in a teicoplanin-resistant derivative of methicillin-resistant Staphylococcus aureus . . Antimicrob Agents Chemother 48:, 2958–2965. [CrossRef] [PubMed]
    [Google Scholar]
  37. Sakoulas G. , Eliopoulos G. M. , Moellering R. C. Jr , Wennersten C. , Venkataraman L. , Novick R. P. , Gold H. S. . ( 2002; ). Accessory gene regulator (agr) locus in geographically diverse Staphylococcus aureus isolates with reduced susceptibility to vancomycin. . Antimicrob Agents Chemother 46:, 1492–1502. [CrossRef] [PubMed]
    [Google Scholar]
  38. Sakoulas G. , Moellering R. C. Jr , Eliopoulos G. M. . ( 2006; ). Adaptation of methicillin-resistant Staphylococcus aureus in the face of vancomycin therapy. . Clin Infect Dis 42: (Suppl 1), S40–S50. [CrossRef] [PubMed]
    [Google Scholar]
  39. Shoji M. , Cui L. , Iizuka R. , Komoto A. , Neoh H. M. , Watanabe Y. , Hishinuma T. , Hiramatsu K. . ( 2011; ). walK and clpP mutations confer reduced vancomycin susceptibility in Staphylococcus aureus . . Antimicrob Agents Chemother 55:, 3870–3881. [CrossRef] [PubMed]
    [Google Scholar]
  40. Song J. H. , Hiramatsu K. , Suh J. Y. , Ko K. S. , Ito T. , Kapi M. , Kiem S. , Kim Y. S. , Oh W. S. . & other authors ( 2004; ). Emergence in Asian countries of Staphylococcus aureus with reduced susceptibility to vancomycin. . Antimicrob Agents Chemother 48:, 4926–4928. [CrossRef] [PubMed]
    [Google Scholar]
  41. Tenover F. C. , McDonald L. C. . ( 2005; ). Vancomycin-resistant staphylococci and enterococci: epidemiology and control. . Curr Opin Infect Dis 18:, 300–305. [CrossRef] [PubMed]
    [Google Scholar]
  42. Tristan A. , Bes M. , Meugnier H. , Lina G. , Bozdogan B. , Courvalin P. , Reverdy M. E. , Enright M. C. , Vandenesch F. , Etienne J. . ( 2007; ). Global distribution of Panton–Valentine leukocidin–positive methicillin-resistant Staphylococcus aureus, 2006. . Emerg Infect Dis 13:, 594–600. [CrossRef] [PubMed]
    [Google Scholar]
  43. Tsuji B. T. , Rybak M. J. , Lau K. L. , Sakoulas G. . ( 2007; ). Evaluation of accessory gene regulator (agr) group and function in the proclivity towards vancomycin intermediate resistance in Staphylococcus aureus . . Antimicrob Agents Chemother 51:, 1089–1091. [CrossRef] [PubMed]
    [Google Scholar]
  44. Vandenesch F. , Naimi T. , Enright M. C. , Lina G. , Nimmo G. R. , Heffernan H. , Liassine N. , Bes M. , Greenland T. . & other authors ( 2003; ). Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton–Valentine leukocidin genes: worldwide emergence. . Emerg Infect Dis 9:, 978–984.[PubMed] [CrossRef]
    [Google Scholar]
  45. Vaudaux P. , Francois P. , Bisognano C. , Kelley W. L. , Lew D. P. , Schrenzel J. , Proctor R. A. , McNamara P. J. , Peters G. , Von Eiff C. . ( 2002; ). Increased expression of clumping factor and fibronectin-binding proteins by hemB mutants of Staphylococcus aureus expressing small colony variant phenotypes. . Infect Immun 70:, 5428–5437. [CrossRef] [PubMed]
    [Google Scholar]
  46. Walsh T. R. , Howe R. A. . ( 2002; ). The prevalence and mechanisms of vancomycin resistance in Staphylococcus aureus . . Annu Rev Microbiol 56:, 657–675. [CrossRef] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.035204-0
Loading
/content/journal/jmm/10.1099/jmm.0.035204-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error