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Multiplex PCR Assay for Typing of Staphylococcal Cassette Chromosome Mec Types I to V in Methicillin-resistant Staphylococcus aureus
Published on: September 5, 2013
Novel Structure of Enterococcus faecium-Originated ermB-Positive Tn1546-Like Element in Staphylococcus aureus
Tsai-Wen Wan1, Wei-Chun Hung2, Jui-Chang Tsai3
1Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.
Abstract:
We determined the resistance determinants in 274 erythromycin-resistant methicillin-susceptible Staphylococcus aureus (MSSA) isolates during a 13-year period, 2000 to 2012. The resistance phenotypes, inducible macrolide-lincosamide-streptogramin (iMLS), constitutive MLS (cMLS), and macrolide-streptogramin (MS) resistance phenotypes, were examined by a double-disk diffusion D test. The ermB gene was more frequent (35%; 97/274) than ermC (27%; 75/274) or ermA (21%; 58/274). All 97 ermB-positive isolates harbored Tn551 and IS1216V The majority (89/97) of ermB-positive isolates displayed the cMLS phenotype and carried mobile element structure (MES)-like structures, which has been previously reported in sequence type 59 (ST59) methicillin-resistant S. aureus (MRSA). The remaining 8 ermB-carrying isolates, belonging to ST7 (n = 4), ST5 (n = 3), and ST59 (n = 1), were sasK intact and did not carry MES-like structures. Unlike a MES-like structure that was located on the chromosome, the ermB elements on sasK-intact isolates were located on plasmids by S1 nuclease pulsed-field gel electrophoresis (PFGE) analysis and conjugation tests. Sequence data for the ermB-containing region (14,566 bp) from ST59 NTUH_3874 revealed that the best match was a Tn1546-like element in plasmid pMCCL2 DNA (GenBank accession number AP009486) of Macrococcus caseolyticus Tn1546 is recognized as an enterococcal transposon and was known from the vancomycin resistance gene cluster in vancomycin-resistant Enterococcus (VRE). So far, acquisitions of Tn1546 in S. aureus have occurred in clonal complex 5 (CC5) MRSA, but not in MSSA. This is the first report that MSSA harbors an Enterococcus faecium-originated ermB-positive Tn1546-like element located on a plasmid.
Insights
This study identified resistance determinants in erythromycin-resistant Staphylococcus aureus (MSSA). The ermB gene, often linked to mobile elements, was prevalent, with a novel plasmid-borne Tn1546-like element found in MSSA.
Area of Science:
- Microbiology
- Genetics
- Antimicrobial Resistance
Background:
- Methicillin-susceptible Staphylococcus aureus (MSSA) can develop resistance to antibiotics like erythromycin.
- Understanding the genetic basis of this resistance is crucial for effective treatment strategies.
Purpose of the Study:
- To determine the resistance determinants in erythromycin-resistant MSSA isolates.
- To investigate the genetic elements and mobile structures associated with macrolide-lincosamide-streptogramin (MLS) resistance phenotypes.
Main Methods:
- Phenotypic characterization of resistance using the double-disk diffusion D test.
- Molecular detection of resistance genes (ermB, ermC, ermA) and mobile genetic elements (Tn551, IS1216V).
- Plasmid analysis using S1 nuclease pulsed-field gel electrophoresis (PFGE) and conjugation tests.
Main Results:
- The ermB gene was the most frequent resistance determinant (35%) in MSSA.
- A majority of ermB-positive isolates displayed the constitutive MLS (cMLS) phenotype and carried mobile element structure (MES)-like elements.
- A novel finding was the presence of an Enterococcus faecium-originated ermB-positive Tn1546-like element on a plasmid in MSSA, previously unobserved in this bacterial species.
Conclusions:
- The ermB gene, often associated with mobile elements and specific resistance phenotypes, is a significant determinant of erythromycin resistance in MSSA.
- The identification of a plasmid-borne Tn1546-like element in MSSA represents a novel mechanism of resistance acquisition, with potential implications for the spread of antibiotic resistance.
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