Transferable Vancomycin Resistance in a Community-Associated MRSA Lineage

被引：121

作者：

Rossi, Flavia ^{[1
,2
]}

Diaz, Lorena ^{[3
,6
]}

Wollam, Aye ^{[9
]}

Panesso, Diana ^{[3
,6
]}

Zhou, Yanjiao ^{[9
]}

Rincon, Sandra ^{[3
]}

Narechania, Apurva ^{[10
]}

Xing, Galen ^{[11
]}

Di Gioia, Thais S. R. ^{[1
,2
]}

Doi, Andre ^{[1
,2
]}

Tran, Truc T. ^{[6
,8
]}

Reyes, Jinnethe ^{[3
,6
]}

Munita, Jose M. ^{[5
,6
]}

Carvajal, Lina P. ^{[3
]}

Hernandez-Roldan, Alejandra ^{[4
,6
]}

Brandao, Denise ^{[1
,2
]}

van der Heijden, Inneke Marie ^{[1
,2
]}

Murray, Barbara E. ^{[6
,7
]}

Planet, Paul J. ^{[10
,11
]}

Weinstock, George M. ^{[9
]}

Arias, Cesar A. ^{[3
,6
,7
]}

机构：

[1] Univ Sao Paulo, Dept Pathol, Cent Lab LIM 03, Div Microbiol,Hosp Clin,Fac Med, Sao Paulo, Brazil

[2] Univ Sao Paulo, Dept Infect Dis LIM 54, Hosp Clin, Fac Med, Sao Paulo, Brazil

[3] Univ Bosque, Mol Genet & Antimicrobial Resistance Unit, Bogota, Colombia

[4] CIDEIM, Cali, Colombia

[5] Univ Desarrollo, Clin Alemana Santiago, Santiago, Chile

[6] Univ Texas Houston, Sch Med, Dept Internal Med, Div Infect Dis, Houston, TX USA

[7] Univ Texas Houston, Sch Med, Dept Microbiol & Mol Genet, Houston, TX USA

[8] Univ Houston, Coll Pharm, Houston, TX 77030 USA

[9] Washington Univ, Genome Inst, St Louis, MO 63130 USA

[10] Amer Museum Nat Hist, Sackler Inst Comparat Genom, New York, NY 10024 USA

[11] Columbia Univ, Div Pediat Infect Dis, New York, NY USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2014年 / 370卷 / 16期

基金：

美国国家卫生研究院;

关键词：

STAPHYLOCOCCUS-AUREUS ISOLATE; GLYCOPEPTIDE RESISTANCE; ENTEROCOCCUS-FAECIUM; PLASMID; IDENTIFICATION; CONNECTION; USA300; LEVEL; CLONE; GENE;

D O I：

10.1056/NEJMoa1303359

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.

引用

页码：1524 / 1531

页数：8

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