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Microb Drug Resist. 2018 Jun;24(5):534-541. doi: 10.1089/mdr.2017.0212. Epub 2017 Oct 23.

Emergence of Daptomycin-Nonsusceptible Methicillin-Resistant Staphylococcus aureus Clinical Isolates Among Daptomycin-Naive Patients in Korea.

Author information

1
1 Department of Internal Medicine, Seoul National University Bundang Hospital , Seongnam, Republic of Korea.
2
2 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Republic of Korea.
3
3 School of Bioresources and Bioscience, Chung-Ang University , Anseong, Republic of Korea.
4
4 Department of Internal Medicine, Chonnam National University Hospital , Gwangju, Republic of Korea.
5
5 Department of Internal Medicine, Chosun University Hospital , Gwangju, Republic of Korea.
6
6 Department of Internal Medicine, Chonbuk National University , Jeonju, Republic of Korea.
7
7 Department of Internal Medicine, Chonnam National University Hwasun Hospital , Hwasun, Republic of Korea.
8
8 Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital , Goyang, Republic of Korea.
9
9 Department of Internal Medicine, Myongji Hospital , Goyang, Republic of Korea.
10
10 Department of Internal Medicine, Inje University Ilsan Paik Hospital , Goyang, Republic of Korea.
11
11 Department of Internal Medicine, Wonkwang University Hospital , Iksan, Republic of Korea.
12
12 Department of Internal Medicine, Dongguk University Ilsan Hospital , Goyang, Republic of Korea.

Abstract

This study was conducted to assess emergence of daptomycin-nonsusceptible (DAP-NS) phenotype in DAP-naive patients with invasive Staphylococcus aureus (ISA) infections in Korea. A total of 208 S. aureus clinical isolates were selected from a previous prospective study on ISA infections and evaluated for DAP-NS. Although DAP has never been introduced in Korea, five DAP-NS S. aureus strains (2.4%) were identified among 208 S. aureus strains collected from ISA infections. The DAP-NS phenotype was observed only in methicillin-resistant S. aureus (MRSA) strains, but not in methicillin-susceptible S. aureus strains. One DAP-NS MRSA strain belonged to sequence type 72 (ST72) and four were ST5 MRSA strains, three of which were heteroresistant vancomycin (VAN)-intermediate S. aureus. All these five DAP-NS MRSA strains were from healthcare-associated infections without prior exposure to VAN within 30 days. While the ST72 MRSA strain exhibited DAP-NS phenotype via charge repulsion mechanism, four ST5 DAP-NS S. aureus strains had charge-independent DAP-NS mechanism. None of the five DAP-NS strains displayed significant increase in cell wall thickness, indicating that altered cell wall thickness was not associated with the observed DAP-NS phenotype.

KEYWORDS:

Staphylococcus aureus; daptomycin resistance; vancomycin

PMID:
29863982
DOI:
10.1089/mdr.2017.0212
[Indexed for MEDLINE]

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