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Related Experiment Videos

Vancomycin susceptibility within methicillin-resistant Staphylococcus aureus lineages.

Robin A Howe1, Alastair Monk, Mandy Wootton

  • 1Southmead Hospital, Bristol, United Kingdom.

Emerging Infectious Diseases
|June 18, 2004
PubMed
Summary

Reduced vancomycin susceptibility in methicillin-resistant Staphylococcus aureus (MRSA) has emerged across diverse genetic backgrounds, not just a single clone. This widespread antimicrobial resistance in successful MRSA strains poses a growing challenge for effective treatment.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Vancomycin-intermediate Staphylococcus aureus (VISA) strains, a form of methicillin-resistant Staphylococcus aureus (MRSA) with reduced vancomycin susceptibility, are increasingly reported globally.
  • The evolutionary trajectory of VISA, whether it arises independently in various genetic backgrounds or through a predominant clone, remains uncertain.

Purpose of the Study:

  • To investigate the genetic diversity and clonal origins of 101 MRSA isolates exhibiting reduced vancomycin susceptibility from nine countries.
  • To determine if VISA emergence is linked to specific MRSA lineages or represents a broader phenomenon across successful clones.

Main Methods:

  • Multilocus sequence typing (MLST) was employed to determine the genetic relatedness of the MRSA isolates.

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  • Characterization of staphylococcal chromosomal cassette mec (SCCmec) and accessory gene regulator (agr) was performed to assess genetic features.
  • Phylogenetic analysis was conducted using MLST data to identify major MRSA lineages.

    • Main Results:

    • Nine distinct genotypes were identified among the 101 MRSA isolates via MLST.
    • Isolates were found within all five major hospital-associated MRSA lineages, indicating broad genetic distribution.
    • A significant majority (88/101) of the isolates belonged to two globally prevalent, early MRSA clones.

    Conclusions:

    • Reduced vancomycin susceptibility has emerged independently in multiple successful and genetically diverse MRSA epidemic lineages.
    • There is no clear clonal predisposition for the development of VISA.
    • The increasing prevalence of antimicrobial resistance in distinct pandemic MRSA clones may complicate the treatment of S. aureus infections.