ArticlePloS one2019
Genomic insights on heterogeneous resistance to vancomycin and teicoplanin in Methicillin-resistant Staphylococcus aureus: A first report from South India.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- The global scope of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA): a meta-analysis of its clinical impact, molecular epidemiology, and diagnostic challenges across 15,165 isolates.BMC infectious diseases · 2026Pooled it
- Borderline Oxacillin-ResistantAntibiotics (Basel, Switzerland) · 2025Article
- Investigation of Various Toxigenic Genes and Antibiotic and Disinfectant Resistance Profiles ofFoods (Basel, Switzerland) · 2024Article
- Unraveling novel mutation patterns and morphological variations in two dalbavancin-resistant MRSA strains in Austria using whole genome sequencing and transmission electron microscopy.BMC infectious diseases · 2024Article
- Presence of multiple van genes among glycopeptide non-susceptible Staphylococcus aureus exhibiting in vitro MIC creep phenomenon: A study from north-east India.The Indian journal of medical research · 2024Article
- Molecular and Clinical Features of Heterogeneous Vancomycin-IntermediateSultan Qaboos University medical journal · 2023Article
- Antimicrobial Resistance ofAntibiotics (Basel, Switzerland) · 2023Article
- Comparative Genomics Identifies Novel Genetic Changes Associated with Oxacillin, Vancomycin and Daptomycin Susceptibility in ST100 Methicillin-ResistantAntibiotics (Basel, Switzerland) · 2023Article
- Teicoplanin associated geneFrontiers in microbiology · 2023Article
- Heterogeneous Vancomycin IntermediateInfection and drug resistance · 2023Article
- Molecular Basis of Non-β-Lactam Antibiotics Resistance inAntibiotics (Basel, Switzerland) · 2022Review
- Molecular Mechanisms of Drug Resistance inInternational journal of molecular sciences · 2022Review
- Clinical effect of teicoplanin on pulmonary infection after chemotherapy for hematologic malignancies.American journal of translational research · 2022Article
- Efficacy of Cathelicidin LL-37 in an MRSA Wound Infection Mouse Model.Antibiotics (Basel, Switzerland) · 2021Article
- Vancomycin heteroresistance inFuture science OA · 2021Article
- Vancomycin MIC and agr dysfunction in invasive MRSA infections in southern Brazil.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2020Article
- Genetic Relatedness and Diversity ofMicroorganisms · 2020Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infection is an important clinical concern in patients, and is often associated with significant disease burden and metastatic infections. There is an increasing evidence of heterogeneous vancomycin-intermediate S. aureus (hVISA) associated treatment failure. In this study, we aim to understand the molecular mechanism of teicoplanin resistant MRSA (TR-MRSA) and hVISA. A total of 482 MRSA isolates were investigated for these phenotypes. Of the tested isolates, 1% were identified as TR-MRSA, and 12% identified as hVISA. A highly diverse amino acid substitution was observed in tcaRAB, vraSR, and graSR genes in TR-MRSA and hVISA strains. Interestingly, 65% of hVISA strains had a D148Q mutation in the graR gene. However, none of the markers were reliable in differentiating hVISA from TR-MRSA. Significant pbp2 upregulation was noted in three TR-MRSA strains, which had teicoplanin MICs of 16 or 32 μg/ml, whilst significant pbp4 downregulation was not noted in these strains. In our study, multiple mutations were identified in the candidate genes, suggesting a complex evolutionary pathway involved in the development of TR-MRSA and hVISA strains.
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