ArticleAntimicrobial agents and chemotherapy2016
First Report of cfr-Carrying Plasmids in the Pandemic Sequence Type 22 Methicillin-Resistant Staphylococcus aureus Staphylococcal Cassette Chromosome mec Type IV Clone.
Article in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 45 citations in OpenAlex.
- Whole-Genome Sequencing of Linezolid-Resistant and Linezolid-Intermediate-SusceptibilityMicroorganisms · 2025Article
- Mucoid Staphylococcus haemolyticus: an unheeded multidrug-resistant pathogen.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2023Article
- Molecular epidemiology and characterization of antimicrobial-resistantFrontiers in cellular and infection microbiology · 2023Article
- Vancomycin Resistance inMicroorganisms · 2022Review
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- Mobile Oxazolidinone Resistance Genes in Gram-Positive and Gram-Negative Bacteria.Clinical microbiology reviews · 2021Article
- Characterization of florfenicol resistance genes in the coagulase-negative Staphylococcus (CoNS) isolates and genomic features of a multidrug-resistant Staphylococcus lentus strain H29.Antimicrobial resistance and infection control · 2021Article
- Global Expansion of Linezolid-Resistant Coagulase-Negative Staphylococci.Frontiers in microbiology · 2021Article
- Article
- Livestock-Associated Methicillin-ResistantFoods (Basel, Switzerland) · 2020Article
- Methicillin-ResistantInfectious diseases · 2020Review
- Presence and Characterization of a NovelFrontiers in microbiology · 2020Article
- Staphylococcal Plasmids, Transposable and Integrative Elements.Microbiology spectrum · 2018Review
- Mobile Genetic Elements Associated with Antimicrobial Resistance.Clinical microbiology reviews · 2018Review
- The human clone ST22 SCCmec IV methicillin-resistant Staphylococcus aureus isolated from swine herds and wild primates in Nepal: is man the common source?FEMS microbiology ecology · 2018Article
- Mechanisms of Bacterial Resistance to Antimicrobial Agents.Microbiology spectrum · 2018Article
- Clinical case of cfr-positive MRSA CC398 in Belgium.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Bacteria from Animals as a Pool of Antimicrobial Resistance Genes.Antibiotics (Basel, Switzerland) · 2017Review
- Pleuromutilins: Potent Drugs for Resistant Bugs-Mode of Action and Resistance.Cold Spring Harbor perspectives in medicine · 2017Review
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Linezolid is often the drug of last resort for serious methicillin-resistant Staphylococcus aureus (MRSA) infections. Linezolid resistance is mediated by mutations in 23S rRNA and genes for ribosomal proteins; cfr, encoding phenicol, lincosamide, oxazolidinone, pleuromutilin, and streptogramin A (PhLOPSA) resistance; its homologue cfr(B); or optrA, conferring oxazolidinone and phenicol resistance. Linezolid resistance is rare in S. aureus, and cfr is even rarer. This study investigated the clonality and linezolid resistance mechanisms of two MRSA isolates from patients in separate Irish hospitals. Isolates were subjected to cfr PCR, PhLOPSA susceptibility testing, 23S rRNA PCR and sequencing, DNA microarray profiling, spa typing, pulsed-field gel electrophoresis (PFGE), plasmid curing, and conjugative transfer. Whole-genome sequencing was used for single-nucleotide variant (SNV) analysis, multilocus sequence typing, L protein mutation identification, cfr plasmid sequence analysis, and optrA and cfr(B) detection. Isolates M12/0145 and M13/0401 exhibited linezolid MICs of 64 and 16 mg/liter, respectively, and harbored identical 23S rRNA and L22 mutations, but M12/0145 exhibited the mutation in 2/6 23S rRNA alleles, compared to 1/5 in M13/0401. Both isolates were sequence type 22 MRSA staphylococcal cassette chromosome mec type IV (ST22-MRSA-IV)/spa type t032 isolates, harbored cfr, exhibited the PhLOPSA phenotype, and lacked optrA and cfr(B). They differed by five PFGE bands and 603 SNVs. Isolate M12/0145 harbored cfr and fexA on a 41-kb conjugative pSCFS3-type plasmid, whereas M13/0401 harbored cfr and lsa(B) on a novel 27-kb plasmid. This is the first report of cfr in the pandemic ST22-MRSA-IV clone. Different cfr plasmids and mutations associated with linezolid resistance in genotypically distinct ST22-MRSA-IV isolates highlight that prudent management of linezolid use is essential.
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