Abstract
Vancomycin is usually reserved for treatment of serious infections, including those caused by multidrug-resistant Staphylococcus aureus. A clinical isolate of S. aureus with high-level resistance to vancomycin (minimal inhibitory concentration = 1024 microg/ml) was isolated in June 2002. This isolate harbored a 57.9-kilobase multiresistance conjugative plasmid within which Tn1546 (vanA) was integrated. Additional elements on the plasmid encoded resistance to trimethoprim (dfrA), beta-lactams (blaZ), aminoglycosides (aacA-aphD), and disinfectants (qacC). Genetic analyses suggest that the long-anticipated transfer of vancomycin resistance to a methicillin-resistant S. aureus occurred in vivo by interspecies transfer of Tn1546 from a co-isolate of Enterococcus faecalis.
Publication types
-
Research Support, U.S. Gov't, P.H.S.
MeSH terms
-
Anti-Bacterial Agents / pharmacology
-
Bacterial Proteins / genetics*
-
Carbon-Oxygen Ligases / genetics*
-
Conjugation, Genetic
-
DNA Transposable Elements*
-
Drug Resistance, Multiple, Bacterial / genetics
-
Enterococcus faecalis / drug effects
-
Enterococcus faecalis / genetics*
-
Enterococcus faecalis / isolation & purification
-
Genes, Bacterial
-
Humans
-
Methicillin Resistance / genetics
-
Microbial Sensitivity Tests
-
Molecular Sequence Data
-
Plasmids
-
R Factors*
-
Recombination, Genetic
-
Renal Dialysis
-
Staphylococcus aureus / drug effects*
-
Staphylococcus aureus / genetics*
-
Staphylococcus aureus / isolation & purification
-
Vancomycin / pharmacology
-
Vancomycin Resistance / genetics*
Substances
-
Anti-Bacterial Agents
-
Bacterial Proteins
-
DNA Transposable Elements
-
VanA ligase, Bacteria
-
Vancomycin
-
Carbon-Oxygen Ligases