1887

Abstract

A meticillin-resistant (MRSA) strain with additional β-lactam-inducible aminoglycoside resistance was previously reported by a group at the Kitasato University in Japan. In addition to gentamicin, the ‘Kitasato strain’ was resistant to arbekacin (ABK), which is primarily used as an anti-MRSA aminoglycoside. No further studies regarding the spread of MRSA strains with the newly identified resistance mechanism have been reported to date. To obtain epidemiological data on MRSA strains with the antagonistic resistance and to analyse their genetic features, we examined the emergence of β-lactam-inducible ABK-resistant MRSA strains at our university hospital using longitudinal analysis. Among the 396 isolates, 35 (8.8 %) were found to be ABK-resistant MRSA strains (the resistance being induced by β-lactams). Moreover, based on the pulsed-field gel electrophoresis profiles, the clonality of those MRSA strains changed at different time periods. In the Kitasato strain, the antagonistic mechanism was clearly demonstrated by the integration of transposable elements; a Tn-IS hybrid structure that contained an aminoglycoside resistance gene cointegrated into a region downstream of the β-lactamase gene. In most of the MRSA strains detected in our study, the antagonistic interaction was explained by the same mechanism as that found in the Kitasato strain. Interestingly, sequence analysis showed that all of our strains carried IS insertion sites which were different from those of the Kitasato strain. This study shows that MRSA strains with the additional antagonistic resistance are not uncommon and have been increasingly disseminating in clinical settings.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.065276-0
2014-05-01
2019-10-20
Loading full text...

Full text loading...

/deliver/fulltext/jmm/63/5/710.html?itemId=/content/journal/jmm/10.1099/jmm.0.065276-0&mimeType=html&fmt=ahah

References

  1. Berg T., Firth N., Apisiridej S., Hettiaratchi A., Leelaporn A., Skurray R. A.. ( 1998;). Complete nucleotide sequence of pSK41: evolution of staphylococcal conjugative multiresistance plasmids. . J Bacteriol 180:, 4350–4359.[PubMed]
    [Google Scholar]
  2. Blanc D. S., Struelens M. J., Deplano A., De Ryck R., Hauser P. M., Petignat C., Francioli P.. ( 2001;). Epidemiological validation of pulsed-field gel electrophoresis patterns for methicillin-resistant Staphylococcus aureus. . J Clin Microbiol 39:, 3442–3445. [CrossRef][PubMed]
    [Google Scholar]
  3. Byrne M. E., Gillespie M. T., Skurray R. A.. ( 1990;). Molecular analysis of a gentamicin resistance transposonlike element on plasmids isolated from North American Staphylococcus aureus strains. . Antimicrob Agents Chemother 34:, 2106–2113. [CrossRef][PubMed]
    [Google Scholar]
  4. CLSI (2006). Performance Standards for Antimicrobial Susceptibility Testing; 16th Informational Supplement M100-S16. Wayne, PA: Clinical and Laboratory Standards Institute.
  5. Hamada Y., Tamura K., Koyama I., Kuroyama M., Yago K., Sunakawa K.. ( 2011;). Clinical efficacy of arbekacin for Gram-negative bacteria. . J Infect Chemother 17:, 876–879. [CrossRef][PubMed]
    [Google Scholar]
  6. Hamilton-Miller J. M., Shah S.. ( 1995;). Activity of the semi-synthetic kanamycin B derivative, arbekacin against methicillin-resistant Staphylococcus aureus. . J Antimicrob Chemother 35:, 865–868. [CrossRef][PubMed]
    [Google Scholar]
  7. Hwang J. H., Lee J. H., Moon M. K., Kim J. S., Won K. S., Lee C. S.. ( 2012;). The usefulness of arbekacin compared to vancomycin. . Eur J Clin Microbiol Infect Dis 31:, 1663–1666. [CrossRef][PubMed]
    [Google Scholar]
  8. Ida T., Okamoto R., Nonoyama M., Irinoda K., Kurazono M., Inoue M.. ( 2002;). Antagonism between aminoglycosides and β-lactams in a methicillin-resistant Staphylococcus aureus isolate involves induction of an aminoglycoside-modifying enzyme. . Antimicrob Agents Chemother 46:, 1516–1521. [CrossRef][PubMed]
    [Google Scholar]
  9. Kozitskaya S., Cho S. H., Dietrich K., Marre R., Naber K., Ziebuhr W.. ( 2004;). The bacterial insertion sequence element IS256 occurs preferentially in nosocomial Staphylococcus epidermidis isolates: association with biofilm formation and resistance to aminoglycosides. . Infect Immun 72:, 1210–1215. [CrossRef][PubMed]
    [Google Scholar]
  10. Lange C. C., Werckenthin C., Schwarz S.. ( 2003;). Molecular analysis of the plasmid-borne aacA/aphD resistance gene region of coagulase-negative staphylococci from chickens. . J Antimicrob Chemother 51:, 1397–1401. [CrossRef][PubMed]
    [Google Scholar]
  11. Lee D. G., Chun H. S., Yim D. S., Choi S. M., Choi J. H., Yoo J. H., Shin W. S., Kang M. W.. ( 2003;). Efficacies of vancomycin, arbekacin, and gentamicin alone or in combination against methicillin-resistant Staphylococcus aureus in an in vitro infective endocarditis model. . Antimicrob Agents Chemother 47:, 3768–3773. [CrossRef][PubMed]
    [Google Scholar]
  12. Liu C., Bayer A., Cosgrove S. E., Daum R. S., Fridkin S. K., Gorwitz R. J., Kaplan S. L., Karchmer A. W., Levine D. P.. & other authors ( 2011;). Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. . Clin Infect Dis 52:, e18–e55. [CrossRef][PubMed]
    [Google Scholar]
  13. McDougal L. K., Steward C. D., Killgore G. E., Chaitram J. M., McAllister S. K., Tenover F. C.. ( 2003;). Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database. . J Clin Microbiol 41:, 5113–5120. [CrossRef][PubMed]
    [Google Scholar]
  14. Rouch D. A., Byrne M. E., Kong Y. C., Skurray R. A.. ( 1987;). The aacA-aphD gentamicin and kanamycin resistance determinant of Tn4001 from Staphylococcus aureus: expression and nucleotide sequence analysis. . J Gen Microbiol 133:, 3039–3052.[PubMed]
    [Google Scholar]
  15. Rowland S. J., Dyke K. G.. ( 1990;). Tn552, a novel transposable element from Staphylococcus aureus. . Mol Microbiol 4:, 961–975. [CrossRef][PubMed]
    [Google Scholar]
  16. Saito A.. ( 1995;). Clinical breakpoints for antimicrobial agents in pulmonary infections and sepsis: Report of the Committee for Japanese Standards for Antimicrobial Susceptibility Testing for Bacteria. . J Infect Chemother 1:, 83–88. [CrossRef]
    [Google Scholar]
  17. Tenover F. C., Arbeit R. D., Goering R. V., Mickelsen P. A., Murray B. E., Persing D. H., Swaminathan B.. ( 1995;). Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. . J Clin Microbiol 33:, 2233–2239.[PubMed]
    [Google Scholar]
  18. Tsuchimochi N., Uchida Y., Nagasaki Y., Eriguchi Y., Maehara Y., Kadowaki M., Shimono N.. ( 2007;). Combined antibacterial effects of between meropenem and vancomycin, teicoplanin, linezolid, or arbekacin in methicillin-resistant Staphylococcus aureus. . Jpn J Chemother 55:, 363–367.
    [Google Scholar]
  19. Uchida Y., Mochimaru T., Morokuma Y., Kiyosuke M., Fujise M., Eto F., Eriguchi Y., Nagasaki Y., Shimono N., Kang D.. ( 2010;). Clonal spread in Eastern Asia of ciprofloxacin-resistant Escherichia coli serogroup O25 strains, and associated virulence factors. . Int J Antimicrob Agents 35:, 444–450. [CrossRef][PubMed]
    [Google Scholar]
  20. Udou T.. ( 2004;). Dissemination of nosocomial multiple-aminoglycoside-resistant Staphylococcus aureus caused by horizontal transfer of the resistance determinant (aacA/aphD) and clonal spread of resistant strains. . Am J Infect Control 32:, 215–219. [CrossRef][PubMed]
    [Google Scholar]
  21. Watanabe T., Ohashi K., Matsui K., Kubota T.. ( 1997;). Comparative studies of the bactericidal, morphological and post-antibiotic effects of arbekacin and vancomycin against methicillin-resistant Staphylococcus aureus. . J Antimicrob Chemother 39:, 471–476. [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.065276-0
Loading
/content/journal/jmm/10.1099/jmm.0.065276-0
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