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In-Host Emergence of Linezolid Resistance in a Complex Pattern of Toxic Shock Syndrome Toxin-1-Positive Methicillin-Resistant Staphylococcus aureus Colonization in Siblings with Cystic Fibrosis.
- Source :
-
Toxins [Toxins (Basel)] 2021 Apr 28; Vol. 13 (5). Date of Electronic Publication: 2021 Apr 28. - Publication Year :
- 2021
-
Abstract
- Methicillin-resistant Staphylococcus aureus (MRSA) can cause chronic lung infections in patients with Cystic Fibrosis (CF). One option for managing them is the use of linezolid. We hereby report the in-host emergence of linezolid resistance (LR) in MRSA in CF siblings via a population analysis. A collection of 171 MRSA strains from 68 samples were characterized by determining their linezolid Minimal Inhibitory Concentrations (MICs), analyzing the locus of staphylococcal protein A ( spa ) and whole genome sequencing. Courses of linezolid were retraced. Strains belonged to three spa types (t002, t045, t127) and two sequence types (ST1, ST5). Emergence of LR occurred under treatment, one year apart in both siblings, in the CC5-MRSA-I Geraldine clone harboring the toxic shock syndrome toxin-1-encoding gene. Resistance was related to a G2576T substitution present in a variable number of 23S rRNA gene copies. Susceptible and resistant strains were co-isolated within samples. Single Nucleotide Polymorphism-based analysis revealed complex colonizations by highly diversified, clonally related populations. LR remains rare in MRSA and there are very few longitudinal analyses documenting its emergence. Analyzing a large MRSA collection revealed new aspects of LR emergence: it emerges in specific subclonal lineages resulting from adaptive diversification of MRSA in the CF lung and this heterogeneity of intra-sample resistance may contribute to compromising antibiotic management.
- Subjects :
- Adolescent
Child
Cystic Fibrosis microbiology
Drug Resistance, Bacterial
Drug Resistance, Multiple, Bacterial genetics
Female
Genotyping Techniques
Humans
Linezolid pharmacology
Methicillin-Resistant Staphylococcus aureus genetics
Microbial Sensitivity Tests
Multilocus Sequence Typing
Shock, Septic drug therapy
Siblings
Staphylococcal Infections microbiology
Whole Genome Sequencing
Cystic Fibrosis complications
Linezolid therapeutic use
Methicillin-Resistant Staphylococcus aureus drug effects
Shock, Septic microbiology
Staphylococcal Infections drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2072-6651
- Volume :
- 13
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Toxins
- Publication Type :
- Academic Journal
- Accession number :
- 33925199
- Full Text :
- https://doi.org/10.3390/toxins13050317