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首页> 外文期刊>Antimicrobial agents and chemotherapy. >First Report of cfr-Carrying Plasmids in the Pandemic Sequence Type 22 Methicillin-Resistant Staphylococcus aureus Staphylococcal Cassette Chromosome mec Type IV Clone
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First Report of cfr-Carrying Plasmids in the Pandemic Sequence Type 22 Methicillin-Resistant Staphylococcus aureus Staphylococcal Cassette Chromosome mec Type IV Clone

机译：大流行序列中耐甲氧西林金黄色葡萄球菌金黄色葡萄球菌盒式染色体mec IV型克隆的cfr携带质粒的首次报道

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Linezolid is often the drug of last resort for serious methicillin-resistant Staphylococcus aureus (MRSA) infections. Linezolid resistance is mediated by mutations in 23S rRNA and genes for ribosomal proteins; cfr, encoding phenicol, lincosamide, oxazolidinone, pleuromutilin, and streptogramin A (PhLOPSA) resistance; its homologue cfr(B); or optrA, conferring oxazolidinone and phenicol resistance. Linezolid resistance is rare in S. aureus, and cfr is even rarer. This study investigated the clonality and linezolid resistance mechanisms of two MRSA isolates from patients in separate Irish hospitals. Isolates were subjected to cfr PCR, PhLOPSA susceptibility testing, 23S rRNA PCR and sequencing, DNA microarray profiling, spa typing, pulsed-field gel electrophoresis (PFGE), plasmid curing, and conjugative transfer. Whole-genome sequencing was used for single-nucleotide variant (SNV) analysis, multilocus sequence typing, L protein mutation identification, cfr plasmid sequence analysis, and optrA and cfr(B) detection. Isolates M12/0145 and M13/0401 exhibited linezolid MICs of 64 and 16 mg/liter, respectively, and harbored identical 23S rRNA and L22 mutations, but M12/0145 exhibited the mutation in 2/6 23S rRNA alleles, compared to 1/5 in M13/0401. Both isolates were sequence type 22 MRSA staphylococcal cassette chromosome mec type IV (ST22-MRSA-IV)/spa type t032 isolates, harbored cfr, exhibited the PhLOPSA phenotype, and lacked optrA and cfr(B). They differed by five PFGE bands and 603 SNVs. Isolate M12/0145 harbored cfr and fexA on a 41-kb conjugative pSCFS3-type plasmid, whereas M13/0401 harbored cfr and lsa(B) on a novel 27-kb plasmid. This is the first report of cfr in the pandemic ST22-MRSA-IV clone. Different cfr plasmids and mutations associated with linezolid resistance in genotypically distinct ST22-MRSA-IV isolates highlight that prudent management of linezolid use is essential.
机译：利奈唑胺通常是严重耐甲氧西林金黄色葡萄球菌（MRSA）感染的最后手段。利奈唑胺抗性是由23S rRNA和核糖体蛋白基因的突变介导的。 cfr，编码苯酚，林可酰胺，恶唑烷酮，截短侧耳素和链霉菌素A（PhLOPSA）的抗药性;其同源物cfr（B）;或optrA，赋予恶唑烷酮和苯酚抗药性。利奈唑胺对金黄色葡萄球菌的抵抗力在金黄色葡萄球菌中罕见，而cfr更为罕见。这项研究调查了来自不同爱尔兰医院患者的两种MRSA分离株的克隆性和利奈唑胺耐药机制。对分离物进行cfr PCR，PhLOPSA敏感性测试，23S rRNA PCR和测序，DNA微阵列分析，spa分型，脉冲场凝胶电泳（PFGE），质粒固化和共轭转移。全基因组测序用于单核苷酸变异（SNV）分析，多基因座序列分型，L蛋白突变鉴定，cfr质粒序列分析以及optrA和cfr（B）检测。分离株M12 / 0145和M13 / 0401的利奈唑胺MIC分别为64和16 mg / L，并具有相同的23S rRNA和L22突变，但M12 / 0145的2/6 23S rRNA等位基因具有突变，而1/5在M13 / 0401中。两种分离株均为序列类型22的MRSA葡萄球菌盒式染色体mec IV型序列（ST22-MRSA-IV）/ spa型t032分离株，具有cfr，表现出PhLOPSA表型，缺乏optrA和cfr（B）。它们相差五个PFGE频段和603个SNV。分离株M12 / 0145在一个41kb的共轭pSCFS3型质粒上带有cfr和fexA，而M13 / 0401在一个新颖的27kb的质粒上带有cfr和lsa（B）。这是大流行ST22-MRSA-IV克隆中cfr的首次报道。在基因型上不同的ST22-MRSA-IV分离株中，不同的cfr质粒和与利奈唑胺抗性相关的突变突出表明，谨慎管理利奈唑胺的使用至关重要。

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