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Detection of heterogeneous vancomycin intermediate resistance in MRSA isolates from Latin America.
Castro, Betsy E; Berrio, Maritza; Vargas, Monica L; Carvajal, Lina P; Millan, Lina V; Rios, Rafael; Hernandez, Angie K; Rincon, Sandra; Cubides, Paola; Forero, Erika; Dinh, An; Seas, Carlos; Munita, Jose M; Arias, Cesar A; Reyes, Jinnethe; Diaz, Lorena.
Afiliação
  • Castro BE; 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; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Carvajal LP; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Millan LV; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Rios R; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Hernandez AK; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Rincon S; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Cubides P; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
  • Forero E; 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, Texas, USA.
  • 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, Texas, USA.
  • Arias CA; Genomics and Resistant Microbes (GeRM) Group, Clínica Alemana de Santiago, Universidad del Desarrollo School of Medicine, Santiago, Chile.
  • Reyes J; Millennium Initiative for Collaborative Research On Bacterial Resistance (MICROB-R), Santiago, Chile.
  • Diaz L; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia.
J Antimicrob Chemother ; 75(9): 2424-2431, 2020 09 01.
Article em En | MEDLINE | ID: mdl-32562543
BACKGROUND: Vancomycin is a common first-line option for MRSA infections. The heterogeneous vancomycin-intermediate 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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Staphylococcus aureus Resistente à Meticilina Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: J Antimicrob Chemother Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Staphylococcus aureus Resistente à Meticilina Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: J Antimicrob Chemother Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido