First detection of an invasive Staphylococcus aureus strain (D958) with reduced susceptibility to glycopeptides in Saudi Arabia

Autor: Jacques Schrenzel, Abdessalam Cherkaoui, S. Al-Obeid, Patrice Francois, Q. Haddad
Rok vydání: 2010
Předmět:
Methicillin-Resistant Staphylococcus aureus/*drug effects/*isolation & purification
Male
Serum
Vancomycin Resistance
Staphylococcal Infections/*microbiology
medicine.disease_cause
Cluster Analysis
ddc:616
Sepsis/*microbiology
Teicoplanin
Vancomycin/analysis/*pharmacology/therapeutic use
Chromosomes
Bacterial
Staphylococcal Infections
Anti-Bacterial Agents
Bacterial Typing Techniques
DNA
Bacterial/genetics
Blood
Staphylococcus aureus
Vancomycin
Serum/chemistry
medicine.drug
Plasmids
Microbiology (medical)
DNA
Bacterial
Methicillin-Resistant Staphylococcus aureus
Genotype
Saudi Arabia
Microbial Sensitivity Tests
Biology
Staphylococcal infections
Microbiology
Anti-Bacterial Agents/analysis/*pharmacology/therapeutic use
Sepsis
medicine
Humans
Etest
Aged
Microbial Viability
Lysostaphin
SCCmec
Microbial Viability/drug effects
Bacteriology
biochemical phenomena
metabolism
and nutrition
medicine.disease
Teicoplanin/pharmacology
Microarray Analysis
Methicillin-resistant Staphylococcus aureus
DNA Fingerprinting
Blood/microbiology
Genes
Bacterial
Lysostaphin/pharmacology
Zdroj: Journal of Clinical Microbiology, Vol. 48, No 6 (2010) pp. 2199-2204
ISSN: 1098-660X
0095-1137
Popis: Strain D958, a methicillin-resistant Staphylococcus aureus strain with reduced susceptibility to vancomycin, was isolated from a 69-year-old Saudi male patient presenting with severe sepsis immediately after admission. Despite high serum levels of vancomycin, the same S. aureus strain was isolated from five blood culture sets during 1 week. Treatment failure under therapeutic levels of vancomycin prompted us to investigate the resistance profile of this strain in further detail. The MIC values for vancomycin as determined by Etest and microdilution were 3.0 and 2.0 mg/liter, respectively, and remained unchanged during the treatment course. The macro-Etest method showed a MIC of 4 mg/liter. The strain showed liquid vancomycin and lysostaphin MBCs of 2.0 and 5.0 mg/liter, respectively. The isolates were confirmed as heterogeneously vancomycin-intermediate S. aureus (hVISA) by vancomycin population analysis profile. The areas under these curves were similar for Mu3 and D958 for vancomycin and teicoplanin (ratio values were 1 and 1.1 for vancomycin and teicoplanin, respectively). Extensive genotyping and molecular characterization demonstrated that the strain harbored a staphylococcal cassette chromosome mec element (SCC mec ) type III cassette and was of sequence type ST241, a single-locus variant of the successful multiresistant clone ST239. Microarray results demonstrated that D958 contained numerous resistance determinants (generally plasmid or phage encoded). These results suggest that this strain is constitutively expressing an altered susceptibility to vancomycin. Further studies are warranted to assess the clonal distribution of such strains displaying reduced susceptibility to vancomycin prior to any antimicrobial therapy.
Databáze: OpenAIRE
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