Title |
Genetic and Molecular Predictors of High Vancomycin MIC in Staphylococcus aureus Bacteremia Isolates
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Published in |
Journal of Clinical Microbiology, July 2014
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DOI | 10.1128/jcm.01320-14 |
Pubmed ID | |
Authors |
Natasha E. Holmes, John D. Turnidge, Wendy J. Munckhof, J. Owen Robinson, Tony M. Korman, Matthew V. N. O'Sullivan, Tara L. Anderson, Sally A. Roberts, Sanchia J. C. Warren, Geoffrey W. Coombs, Hui-Leen Tan, Wei Gao, Paul D. R. Johnson, Benjamin P. Howden |
Abstract |
Elevated vancomycin minimum inhibitory concentration (MIC) is associated with poor outcomes in Staphylococcus aureus bacteremia (SAB), and is reported in patients with methicillin-susceptible S. aureus (MSSA) bacteremia in the absence of vancomycin treatment. Here, using DNA microarray and phenotype analysis, we investigated genetic predictors and accessory gene regulator (agr) function and their relationship with elevated vancomycin MIC using blood culture isolates from a multi-center bi-national cohort of patients with SAB. Specific clonal complexes were associated with elevated (CC8 [p<0.001]) or low (CC22 [p<0.001], CC88 [p<0.001], CC188 [p=0.002]) vancomycin MIC. agr dysfunction (p=0.014) or agr genotype II (p=0.043) were also associated with elevated vancomycin MIC. Specific resistance and virulence genes were also linked to elevated vancomycin MIC, including blaZ (p=0.002), sea (p<0.001), clfA (p<0.001), splA (p=0.001) and the arginine catabolic mobile element (ACME) locus (p=0.02). These data suggest that inherent organism characteristics may explain the link between elevated vancomycin MIC and poor outcomes in patients with SAB, regardless of the antibiotic treatment received. Consideration of clonal specificity should be included in future research when attempting to ascertain treatment effect or clinical outcomes. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Spain | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 40 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 9 | 23% |
Student > Master | 6 | 15% |
Professor | 5 | 13% |
Student > Ph. D. Student | 4 | 10% |
Student > Bachelor | 3 | 8% |
Other | 9 | 23% |
Unknown | 4 | 10% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 30% |
Immunology and Microbiology | 10 | 25% |
Agricultural and Biological Sciences | 4 | 10% |
Biochemistry, Genetics and Molecular Biology | 4 | 10% |
Nursing and Health Professions | 2 | 5% |
Other | 1 | 3% |
Unknown | 7 | 18% |