Long-lasting successful dissemination of resistance to oxazolidinones in MDR Staphylococcus epidermidis clinical isolates in a tertiary care hospital in France
| Autor: | Dilek Imanci, Delphine Girlich, Philippe Glaser, Philippe Ichai, Laurent Dortet, Rémy A. Bonnin, M Boudon, Elodie Creton, Nicolas Fortineau, Najiby Kassis-Chikhani, Didier Samuel, Thierry Naas |
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| Přispěvatelé: | AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre National de Référence Associé de la Résistance aux Antibiotiques [Hôpital Bicêtre AP-HP] (CNRARA/Service de Microbiologie), Ecologie et Evolution de la Résistance aux Antibiotiques / Ecology and Evolution of Antibiotics Resistance (EERA), Université Paris-Sud - Paris 11 (UP11)-Institut Pasteur [Paris] (IP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Service de Bactériologie-Virologie-Hygiène, Hôpital de Bicêtre, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire Paul Brousse, Villejuif, France, Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Structure, Dynamique, Fonction Et Expression Des Beta-Lactamases À Large Spectre, Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11)-Université Paris-Sud - Paris 11 (UP11)-Centre National de Référence de la Résistance aux Antibiotiques (CNR), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris, Physiopathologie et traitement des maladies du foie, Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Génétique Moléculaire Pharmacogénétique et Hormonologie [CHU Bicêtre], This work was supported by the Assistance Publique – Hôpitaux de Paris, a grant from the Universite´ Paris Sud (EA 7361), the LabEx LERMIT supported by a grant from the French National Research Agency (ANR-10-LABX-33) and the LabEx IBEID., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-11-IDEX-0003,IPS,Idex Paris-Saclay(2011), Centre National de Référence Associé de la Résistance aux Antibiotiques, Institut Pasteur [Paris]-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Sud Orsay-Centre National de la Recherche Scientifique (CNRS), Service de bactériologie-virologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Drug resistance Disease Outbreaks Tertiary Care Centers chemistry.chemical_compound Plasmid Staphylococcus epidermidis [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases 1108 Medical Microbiology Disk Diffusion Antimicrobial Tests Drug Resistance Multiple Bacterial Medicine Pharmacology (medical) MESH: Disease Outbreaks Original Research MESH: Middle Aged biology Broth microdilution Middle Aged Staphylococcal Infections Antimicrobial MESH: RNA Ribosomal 23S 3. Good health Anti-Bacterial Agents RNA Ribosomal 23S Infectious Diseases MESH: Disk Diffusion Antimicrobial Tests MESH: Drug Resistance Multiple Bacteria Female France 0605 Microbiology Microbiology (medical) Modern medicine MESH: Staphylococcus epidermidis 030106 microbiology MESH: Linezolid MESH: Staphylococcal Infections Microbiology 03 medical and health sciences MESH: Anti-Bacterial Agents MESH: Methyltransferases Humans Etest Pharmacology MESH: Tertiary Care Centers MESH: Humans business.industry Linezolid [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry Molecular Biology/Molecular biology Methyltransferases biology.organism_classification MESH: Male MESH: France chemistry 1115 Pharmacology And Pharmaceutical Sciences business MESH: Female |
| Zdroj: | Journal of Antimicrobial Chemotherapy Journal of Antimicrobial Chemotherapy, 2018, 73 (1), pp.41-51. ⟨10.1093/jac/dkx370⟩ Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2018, 73 (1), pp.41-51. ⟨10.1093/jac/dkx370⟩ |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dkx370⟩ |
| Popis: | International audience; Objectives: Patient-and procedure-related changes in modern medicine have turned CoNS into one of the major nosocomial pathogens. Treatments of CoNS infections are challenging owing to the large proportion of MDR strains and oxazolidinones often remain the last active antimicrobial molecules. Here, we have investigated a long-lasting outbreak (2010-13) due to methicillin-and linezolid-resistant (LR) CoNS (n " 168), involving 72 carriers and 49 infected patients. Methods: Antimicrobial susceptibilities were tested by the disc diffusion method and MICs were determined by broth microdilution or Etest. The clonal relationship of LR Staphylococcus epidermidis (LRSE) was first determined using a semi-automated repetitive element palindromic PCR (rep-PCR) method. Then, WGS was performed on all cfr-positive LRSE (n " 30) and LRSE isolates representative of each rep-PCR-defined clone (n " 17). Self-transferability of cfr-carrying plasmids was analysed by filter-mating experiments. Results: This outbreak was caused by the dissemination of three clones (ST2, ST5 and ST22) of LRSE. In these clones, linezolid resistance was caused by (i) mutations in the chromosome-located genes encoding the 23S RNA and L3 and L4 ribosomal proteins, but also by (ii) the dissemination of two different self-conjugative plasmids carrying the cfr gene encoding a 23S RNA methylase. By monitoring linezolid prescriptions in two neighbouring hospitals, we highlighted that the spread of LR-CoNS was strongly associated with linezolid use. Conclusions: Physicians should be aware that plasmid-encoded linezolid resistance has started to disseminate among CoNS and that rational use of oxazolidinones is critical to preserve these molecules as efficient treatment options for MDR Gram-positive pathogens. |
| Databáze: | OpenAIRE |
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