1887

Abstract

A pathogenic vancomycin-resistant (VRSA) isolate (MIC ≥64 μg ml) was obtained from a Kolkata hospital in June 2005. Species identification was confirmed by Gram staining, standard biochemical tests and PCR amplification of the gene, which encodes the thermostable nuclease that is highly specific for . The VRSA isolate was also resistant to beta-lactams (amoxicillin, ampicillin, cefepime, cefotaxime, cefuroxime, cephalexin and meticillin), chloramphenicol, streptomycin, macrolides (erythromycin and roxithromycin), clindamycin, rifampicin and trimethoprim-sulfamethoxazole. However, the isolate was susceptible to gentamicin (an aminoglycoside) and ciprofloxacin (a fluoroquinolone). The resistance to vancomycin was inducible , because the MIC of vancomycin increased from 64 μg ml initially to 1024 μg ml during culture of this VRSA strain in the presence of vancomycin. The VRSA isolate contained a large plasmid (∼53.4 kb) and four small plasmids of ∼6, 5.5, 5.1 and 1.5 kb. The large plasmid of ∼53.4 kb harboured the vancomycin-resistance genes , which was confirmed by PCR amplification using the same plasmid as template and, separately, primers specific for the 2.61 kb gene cluster, (969 bp), (1032 bp) and (609 bp). The VRSA isolate was also positive for . Vancomycin resistance was successfully transferred from this VRSA donor to a vancomycin-sensitive recipient clinical isolate by a broth mating procedure. The MIC of vancomycin for the transconjugant was 32 μg ml, as against 2 μg ml for the parent strain. Nucleotide sequencing of the PCR product showed partial homology with genes of an enterococcal transposon Tn-like element. This is believed to be the first Indian isolate that has been shown to be phenotypically vancomycin-resistant, presumably due to a analogue.

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2008-01-01
2019-10-16
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