Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12304
Title: Genetic and molecular predictors of high vancomycin MIC in Staphylococcus aureus bacteremia isolates.
Authors: Holmes, Natasha E;Turnidge, John D;Munckhof, Wendy J;Robinson, J Owen;Korman, Tony M;O'Sullivan, Matthew V N;Anderson, Tara L;Roberts, Sally A;Warren, Sanchia J C;Coombs, Geoffrey W;Tan, Hui-Leen;Gao, Wei;Johnson, Paul D R;Howden, Benjamin P
Affiliation: Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia Department of Medicine, University of Melbourne, Parkville, Victoria, Australia natasha.holmes@austin.org.au.
SA Pathology, Women's and Children's Hospital, North Adelaide, South Australia, Australia Department of Paediatrics, Pathology and Molecular and Biomedical Science, University of Adelaide, Adelaide, South Australia, Australia.
Infection Management Services, Princess Alexandra Hospital, Wolloongabba, Queensland, Australia Department of Medicine, University of Queensland, St Lucia, Queensland, Australia.
Department of Infectious Diseases, Monash Health, Clayton, Victoria, Australia Department of Medicine, Monash University, Clayton, Victoria, Australia.
Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, New South Wales, Australia Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Department of Infectious Diseases, Royal Hobart Hospital, Hobart, Tasmania, Australia Department of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Auckland District Health Board, Auckland, New Zealand.
Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Royal Perth Hospital, Perth, Western Australia, Australia Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia.
Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia Department of Microbiology, Austin Health, Heidelberg, Victoria, Australia.
Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia Department of Medicine, University of Melbourne, Parkville, Victoria, Australia Department of Microbiology, Monash University, Clayton, Victoria, Australia.
Austin Centre for Infection Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia Department of Microbiology, Austin Health, Heidelberg, Victoria, Australia Department of Microbiology, Monash University, Clayton, Victoria, Australia Microbiological Diagnostic Unit, Department of Microbiology and Immunology, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia.
Issue Date: 16-Jul-2014
Citation: Journal of Clinical Microbiology 2014; 52(9): 3384-93
Abstract: An elevated vancomycin 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 the genetic predictors and accessory gene regulator (agr) function and their relationship with elevated vancomycin MIC using blood culture isolates from a multicenter binational cohort of patients with SAB. Specific clonal complexes were associated with elevated (clonal complex 8 [CC8] [P < 0.001]) or low (CC22 [P < 0.001], CC88 [P < 0.001], and CC188 [P = 0.002]) vancomycin MIC. agr dysfunction (P = 0.014) or agr genotype II (P = 0.043) were also associated with an elevated vancomycin MIC. Specific resistance and virulence genes were also linked to an 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 MICs and poor outcomes in patients with SAB, regardless of the antibiotic treatment received. A consideration of clonal specificity should be included in future research when attempting to ascertain treatment effects or clinical outcomes.
Internal ID Number: 25031442
URI: http://ahro.austin.org.au/austinjspui/handle/1/12304
DOI: 10.1128/JCM.01320-14
URL: http://www.ncbi.nlm.nih.gov/pubmed/25031442
Type: Journal Article
Subjects: Adolescent
Adult
Aged
Anti-Bacterial Agents.pharmacology
Bacteremia.microbiology
Bacterial Proteins.genetics
Child
Child, Preschool
Cohort Studies
Drug Tolerance
Female
Genotype
Humans
Infant
Infant, Newborn
Male
Microarray Analysis
Microbial Sensitivity Tests
Middle Aged
Prospective Studies
Staphylococcal Infections.microbiology
Staphylococcus aureus.drug effects.genetics.isolation & purification
Trans-Activators.genetics
Vancomycin.pharmacology
Virulence Factors.genetics
Young Adult
Appears in Collections:Journal articles

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