ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Clonal Emergence of Invasive Multidrug-Resistant Staphylococcus epidermidis Deconvoluted via a Combination of Whole-Genome Sequencing and Microbiome Analyses.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- The global prevalence of Daptomycin, Tigecycline, Quinupristin/Dalfopristin, and Linezolid-resistant Staphylococcus aureus and coagulase-negative staphylococci strains: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2020Pooled it
- Clonal dissemination of linezolid-resistantInfection prevention in practice · 2026Article
- Evaluation of Changes inOpen forum infectious diseases · 2026Article
- Insertion sequence elements associated with Staphylococcus epidermidis evolution in persistent orthopaedic device-related infections.BMC genomics · 2026Article
- Staphylococci: What Has Changed in the Antibiotic Resistance Profile in the Last Decade-Analysis of Strains Isolated from Hospitalised Patients.Pathogens (Basel, Switzerland) · 2025Article
- Review
- Molecular characterization and genotype of multi-drug resistantBiomolecules & biomedicine · 2025Article
- Article
- Molecular Characterization of Clinical Linezolid-ResistantMicroorganisms · 2023Article
- Contribution of the Oral and Gastrointestinal Microbiomes to Bloodstream Infections in Leukemia Patients.Microbiology spectrum · 2023Article
- Outbreak of OXA-232-producing carbapenem-resistantFrontiers in cellular and infection microbiology · 2023Article
- Look Who's Talking: Host and Pathogen Drivers ofInternational journal of molecular sciences · 2022Review
- Characterization ofPeerJ · 2022Article
- Mobile Oxazolidinone Resistance Genes in Gram-Positive and Gram-Negative Bacteria.Clinical microbiology reviews · 2021Article
- Genomic and Phenotypic Analysis of Linezolid-ResistantMicroorganisms · 2021Article
- High-Resolution Typing ofJournal of clinical microbiology · 2021Article
- Metagenomic next-generation sequencing of rectal swabs for the surveillance of antimicrobial-resistant organisms on the Illumina Miseq and Oxford MinION platforms.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- The Epidome - a species-specific approach to assess the population structure and heterogeneity of Staphylococcus epidermidis colonization and infection.BMC microbiology · 2020Article
- Spread of clonal linezolid-resistant Staphylococcus epidermidis in an intensive care unit associated with linezolid exposure.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Article
Corrections and comments
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Authors and funding
19 authors at 2 institutions in 2 countries.
Funding
Abstract
Background: Pathobionts, 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.