Clonal emergence of invasive multidrug-resistant staphylococcus epidermidis deconvoluted via a combination of whole-genome sequencing and microbiome analyses

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dc.contributor.authorLi, Xiqi
dc.contributor.authorArias, Cesar A.
dc.contributor.authorAitken, Samuel L.
dc.contributor.authorGalloway Peña, Jessica
dc.contributor.authorPanesso, Diana
dc.contributor.authorChang, Michael
dc.contributor.authorDiaz, Lorena
dc.contributor.authorRios, Rafael
dc.contributor.authorNuman, Yazan
dc.contributor.authorGhaoui, Sammi
dc.contributor.authorDebRoy, Sruti
dc.contributor.authorBhatti, Micah M.
dc.contributor.authorSimmons, Dawn E.
dc.contributor.authorRaad, Isaam
dc.contributor.authorHachem, Ray
dc.contributor.authorFolan, Stephanie A.
dc.contributor.authorSahasarabhojane, Pranoti
dc.contributor.authorKalia, Awdhesh
dc.contributor.authorShelburne, Samuel A.
dc.contributor.orcidPanesso, Diana [0000-0002-4049-9702]
dc.date.accessioned2020-05-15T20:26:30Z
dc.date.available2020-05-15T20:26:30Z
dc.date.issued2018
dc.description.abstractenglishPathobionts, bacteria that are typically human commensals but can cause disease, contribute significantly to antimicrobial resistance. Staphylococcus epidermidis is a prototypical pathobiont as it is a ubiquitous human commensal but also a leading cause of healthcare-associated bacteremia. We sought to determine the etiology of a recent increase in invasive S. epidermidis isolates resistant to linezolid. Methods Whole-genome sequencing (WGS) was performed on 176 S. epidermidis bloodstream isolates collected at the MD Anderson Cancer Center in Houston, Texas, between 2013 and 2016. Molecular relationships were assessed via complementary phylogenomic approaches. Abundance of the linezolid resistance determinant cfr was determined in stool samples via reverse-transcription quantitative polymerase chain reaction. Results Thirty-nine of the 176 strains were linezolid resistant (22%). Thirty-one of the 39 linezolid-resistant S. epidermidis infections were caused by a particular clone resistant to multiple antimicrobials that spread among leukemia patients and carried cfr on a 49-kb plasmid (herein called pMB151a). The 6 kb of pMB151a surrounding the cfr gene was nearly 100% identical to a cfr-containing plasmid isolated from livestock-associated staphylococci in China. Analysis of serial stool samples from leukemia patients revealed progressive staphylococcal domination of the intestinal microflora and an increase in cfr abundance following linezolid use. Conclusions The combination of linezolid use plus transmission of a multidrug-resistant clone drove expansion of invasive, linezolid-resistant S. epidermidis. Our results lend support to the notion that a combination of antibiotic stewardship plus infection control measures may help to control the spread of a multidrug-resistant pathobiont.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1093/cid/ciy089
dc.identifier.issn1537-6591
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2859
dc.language.isoeng
dc.publisherOxford University Pressspa
dc.publisher.journalClinical Infectious Diseasesspa
dc.relation.ispartofseriesClinical Infectious Diseases, 1537-6591, Vol 67, Num 3, 2018, pag 398–406spa
dc.relation.urihttps://academic.oup.com/cid/article/67/3/398/4931590
dc.rights.creativecommons2018
dc.rights.localAcceso cerradospa
dc.subject.decsÁntraxspa
dc.subject.decsLinezolidspa
dc.subject.decsMicrobiotaspa
dc.subject.keywordsStaphylococcus epidermidisspa
dc.subject.keywordsWhole-genome sequencingspa
dc.subject.keywordsLinezolid resistancespa
dc.subject.keywordsMicrobiomespa
dc.titleClonal emergence of invasive multidrug-resistant staphylococcus epidermidis deconvoluted via a combination of whole-genome sequencing and microbiome analysesspa
dc.title.translatedClonal emergence of invasive multidrug-resistant staphylococcus epidermidis deconvoluted via a combination of whole-genome sequencing and microbiome analysesspa
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

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