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Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of Enterococcus faecalis

Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of... Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of Enterococcus faecalis Lorena Diaz a , b , Pattarachai Kiratisin c , Rodrigo E. Mendes d , Diana Panesso a , b , Kavindra V. Singh a and Cesar A. Arias a , b a Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, Texas b Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia c Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand d JMI Laboratories, North Liberty, Iowa ABSTRACT Nonmutational resistance to linezolid is due to the presence of cfr , which encodes a methyltransferase responsible for methylation of A2503 in the 23S rRNA. The cfr gene was first described in animal isolates of staphylococci, and more recently, it has been identified in Staphylococcus aureus from human clinical infections, including in an outbreak of methicillin-resistant S. aureus . In enterococci, cfr has been described in an animal isolate of Enterococcus faecalis from China. Here, we report an isolate of linezolid-resistant E. faecalis (603-50427X) recovered from a patient in Thailand who received prolonged therapy with the antibiotic for the treatment of atypical mycobacterial disease. The isolate lacked mutations in the genes coding for 23S rRNA and L3 and L4 ribosomal proteins and belonged to the multilocus sequence type (MLST) 16 (ST16), which is commonly found in enterococcal isolates from animal sources. Resistance to linezolid was associated with the presence of cfr on an ∼97-kb transferable plasmid. The cfr gene environment exhibited DNA sequences similar to those of other cfr -carrying plasmids previously identified in staphylococci (nucleotide identity, 99 to 100%). The cfr -carrying plasmid was transferable by conjugation to a laboratory strain of E. faecalis (OG1RF) but not to Enterococcus faecium or S. aureus . The cfr gene was flanked by IS 256 -like sequences both upstream and downstream. This is the first characterization of the potential horizontal transferability of the cfr gene from a human linezolid-resistant isolate of E. faecalis . http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Antimicrobial Agents and Chemotherapy American Society For Microbiology

Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of Enterococcus faecalis

Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of Enterococcus faecalis

Antimicrobial Agents and Chemotherapy , Volume 56 (7): 3917 – Jul 1, 2012

Abstract

Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of Enterococcus faecalis Lorena Diaz a , b , Pattarachai Kiratisin c , Rodrigo E. Mendes d , Diana Panesso a , b , Kavindra V. Singh a and Cesar A. Arias a , b a Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, Texas b Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia c Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand d JMI Laboratories, North Liberty, Iowa ABSTRACT Nonmutational resistance to linezolid is due to the presence of cfr , which encodes a methyltransferase responsible for methylation of A2503 in the 23S rRNA. The cfr gene was first described in animal isolates of staphylococci, and more recently, it has been identified in Staphylococcus aureus from human clinical infections, including in an outbreak of methicillin-resistant S. aureus . In enterococci, cfr has been described in an animal isolate of Enterococcus faecalis from China. Here, we report an isolate of linezolid-resistant E. faecalis (603-50427X) recovered from a patient in Thailand who received prolonged therapy with the antibiotic for the treatment of atypical mycobacterial disease. The isolate lacked mutations in the genes coding for 23S rRNA and L3 and L4 ribosomal proteins and belonged to the multilocus sequence type (MLST) 16 (ST16), which is commonly found in enterococcal isolates from animal sources. Resistance to linezolid was associated with the presence of cfr on an ∼97-kb transferable plasmid. The cfr gene environment exhibited DNA sequences similar to those of other cfr -carrying plasmids previously identified in staphylococci (nucleotide identity, 99 to 100%). The cfr -carrying plasmid was transferable by conjugation to a laboratory strain of E. faecalis (OG1RF) but not to Enterococcus faecium or S. aureus . The cfr gene was flanked by IS 256 -like sequences both upstream and downstream. This is the first characterization of the potential horizontal transferability of the cfr gene from a human linezolid-resistant isolate of E. faecalis .

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Publisher
American Society For Microbiology
Copyright
Copyright © 2012 by the American society for Microbiology.
ISSN
0066-4804
eISSN
1098-6596
DOI
10.1128/AAC.00419-12
pmid
22491691
Publisher site
See Article on Publisher Site

Abstract

Transferable Plasmid-Mediated Resistance to Linezolid Due to cfr in a Human Clinical Isolate of Enterococcus faecalis Lorena Diaz a , b , Pattarachai Kiratisin c , Rodrigo E. Mendes d , Diana Panesso a , b , Kavindra V. Singh a and Cesar A. Arias a , b a Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, Texas b Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia c Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand d JMI Laboratories, North Liberty, Iowa ABSTRACT Nonmutational resistance to linezolid is due to the presence of cfr , which encodes a methyltransferase responsible for methylation of A2503 in the 23S rRNA. The cfr gene was first described in animal isolates of staphylococci, and more recently, it has been identified in Staphylococcus aureus from human clinical infections, including in an outbreak of methicillin-resistant S. aureus . In enterococci, cfr has been described in an animal isolate of Enterococcus faecalis from China. Here, we report an isolate of linezolid-resistant E. faecalis (603-50427X) recovered from a patient in Thailand who received prolonged therapy with the antibiotic for the treatment of atypical mycobacterial disease. The isolate lacked mutations in the genes coding for 23S rRNA and L3 and L4 ribosomal proteins and belonged to the multilocus sequence type (MLST) 16 (ST16), which is commonly found in enterococcal isolates from animal sources. Resistance to linezolid was associated with the presence of cfr on an ∼97-kb transferable plasmid. The cfr gene environment exhibited DNA sequences similar to those of other cfr -carrying plasmids previously identified in staphylococci (nucleotide identity, 99 to 100%). The cfr -carrying plasmid was transferable by conjugation to a laboratory strain of E. faecalis (OG1RF) but not to Enterococcus faecium or S. aureus . The cfr gene was flanked by IS 256 -like sequences both upstream and downstream. This is the first characterization of the potential horizontal transferability of the cfr gene from a human linezolid-resistant isolate of E. faecalis .

Journal

Antimicrobial Agents and ChemotherapyAmerican Society For Microbiology

Published: Jul 1, 2012

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