Detection of heterogeneous vancomycin intermediate resistance in MRSA isolates from Latin America

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dc.contributor.authorCastro, Betsy E.
dc.contributor.authorBerrio, Maritza
dc.contributor.authorVargas, Mónica L.
dc.contributor.authorCarvajal, Lina P.
dc.contributor.authorMillan, Lina V.
dc.contributor.authorRios, Rafael
dc.contributor.authorHernández, Angie K.
dc.contributor.authorRincon, Sandra
dc.contributor.authorCubides, Paola
dc.contributor.authorForero, Erika
dc.contributor.authorDinh, An
dc.contributor.authorSeas, Carlos
dc.contributor.authorMunita, José
dc.contributor.authorArias, Cesar A.
dc.contributor.authorReyes, Jinnethe
dc.contributor.authorDíaz, Lorena
dc.date.accessioned2021-08-04T18:06:16Z
dc.date.available2021-08-04T18:06:16Z
dc.date.issued2020-06
dc.description.abstractBackground: Vancomycin is a common first-line option for MRSA infections. The heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) phenotype is associated with therapeutic failure. However, hVISAisolates 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 LatinAmerican countries. Methods: We evaluated a total of 1189 vancomycin-susceptible MRSA isolates recovered during 2006–08 and2011–14. After an initial screening of hVISA using glycopeptide-supplemented agar strategies, the detection ofhVISA was performed by Etest (GRD) and Macro-method (MET). Isolates deemed to be hVISA were subjectedto population analysis profile/AUC (PAP/AUC) and WGS for further characterization. Finally, we interrogatedalterations in predicted proteins associated with the development of the VISA phenotype in both hVISA andvancomycin-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 from2006–08 and 2011–14, respectively). Most of the hVISA strains (95%) belonged to clonal complex (CC) 5. Only6/39 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%) aminoacid substitutions in WalK. Additionally, we identified 10 substitutions present only in hVISA isolates, involvingWalK, VraS, RpoB and RpoC proteins. Conclusions: The hVISA phenotype exhibits low frequency in Latin America. Aminoacid substitutions in proteinsinvolved in cell envelope homeostasis and RNA synthesis were commonly identified. Our results suggest thatEtest-based methods are an important alternative for the detection of hVISA clinical isolateses
dc.format.extent8 p.es
dc.identifier.citationJournal of Antimicrobial Chemotherapy, 2020, vol. 75(9)es
dc.identifier.urihttps://doi.org/10.1093/jac/dkaa221es
dc.identifier.urihttp://hdl.handle.net/11447/4225
dc.language.isoenes
dc.subjectVancomycines
dc.subjectPharmacologyes
dc.subjectAnti-Bacterial Agentses
dc.titleDetection of heterogeneous vancomycin intermediate resistance in MRSA isolates from Latin Americaes
dc.typeArticlees

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