Detection of heterogeneous vancomycin intermediate resistance in MRSA isolates from Latin America

Fecha de publicación: 01/01/2020

Autores organización

Autores

Berrio M
Vargas ML
Millan LV
Rios R
Hernandez AK
Cubides P
Forero E
Dinh A
Seas C
Munita JM
Arias CA
Diaz L

Grupos de investigación

Unidad de Genética y Resistencia Antimicrobiana UGRA

Resumen

Background: Vancomycin is a common first-line option for MRSA infections. The heterogeneous vancomycinintermediate Staphylococcus aureus (hVISA) phenotype is associated with therapeutic failure. However, hVISA isolates are usually reported as vancomycin susceptible by routine susceptibility testing procedures. Objectives: To detect and characterize the hVISA phenotype in MRSA isolates causing infections in nine Latin American countries. Methods: We evaluated a total of 1189 vancomycin-susceptible MRSA isolates recovered during 2006 08 and 2011 14. After an initial screening of hVISA using glycopeptide-supplemented agar strategies, the detection of hVISA was performed by Etest (GRD) and Macro-method (MET). Isolates deemed to be hVISA were subjected to population analysis profile/AUC (PAP/AUC) and WGS for further characterization. Finally, we interrogated alterations in predicted proteins associated with the development of the VISA phenotype in both hVISA and vancomycin-susceptible S. aureus (VSSA) genomes. Results: A total of 39 MRSA isolates (3.3%) were classified as hVISA (1.4% and 5.6% in MRSA recovered from 2006 08 and 2011 14, respectively). Most of the hVISA strains (95%) belonged to clonal complex (CC) 5. Only 6/39 hVISA isolates were categorized as hVISA by PAP/AUC, with 6 other isolates close (0.87 0.89) to the cut-off (0.9). The majority of the 39 hVISA isolates exhibited the Leu-14!Ile (90%) and VraT Glu-156!Gly (90%) amino acid substitutions in WalK. Additionally, we identified 10 substitutions present only in hVISA isolates, involving WalK, VraS, RpoB and RpoC proteins. Conclusions: The hVISA phenotype exhibits low frequency in Latin America. Amino acid substitutions in proteins involved in cell envelope homeostasis and RNA synthesis were commonly identified. Our results suggest that Etest-based methods are an important alternative for the detection of hVISA clinical isolates. © 2020 Oxford University Press. All rights reserved.

© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Datos de la publicación

ISSN/ISSNe:: 0305-7453, 1460-2091
Tipo:: Article
Páginas:: 2424-2431
DOI:: 10.1093/jac/dkaa221
PubMed:: 32562543
Enlace a otro recurso:: www.scopus.com

Documentos

No hay documentos

Métricas

Filiaciones

Castro BE:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Berrio M:: Instituto Nacional de Salud, Bogotá, Colombia
Vargas ML:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Carvajal LP:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Millan LV:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Rios R:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Hernandez AK:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Rincon S:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Cubides P:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Forero E:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Dinh A:: Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States
Seas C:: Universidad Peruana Cayetano Heredia, Lima, Peru
Munita JM:: Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States

Genomics and Resistant Microbes (GeRM) Group, Clínica Alemana de Santiago, Universidad Del Desarrollo School of Medicine, Santiago, Chile

Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile
Arias CA:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia

Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States

Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center, Houston, TX, United States

Department of Microbiology and Molecular Genetics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States

Center for Infectious Diseases, School of Public Health, University of Texas McGovern Medical School at Houston, Houston, TX, United States
Reyes J:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia

Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States
Diaz L:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia

Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, United States

Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile

Keywords

Anti-Bacterial Agents; Humans; Latin America; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Staphylococcal Infections; Staphylococcus aureus; Vancomycin; bacterial protein; chloramphenicol; ciprofloxacin; clindamycin; cotrimoxazole; daptomycin; erythromycin; gentamicin; lincosamide; linezolid; macrolide; mikamycin B; minocycline; rifampicin; teicoplanin; tetracycline; vancomycin; antiinfective agent; vancomycin; amino acid substitution; antibiotic resistance; antibiotic resistome; antibiotic sensitivity; Argentina; Article; bacterial genome; bacterium detection; bacterium identification; bacterium isolate; Brazil; Chile; clonal species; Colombia; computer model; controlled study; Ecuador; epsilometer test; evaluation study; genetic procedures; Guatemala; heterogeneous vancomycin intermediate Staphylococcus aureus; macro method; methicillin resistant Staphylococcus aureus; Mexico; nonhuman; Peru; phenotype; phylogeny; population analysis profile method; Staph