ArticleThe Journal of antimicrobial chemotherapy2022
Mechanisms of high-level fosfomycin resistance in Staphylococcus aureus epidemic lineage ST5.
Article in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 15 citations in OpenAlex.
- Decoding the genomic repertoire of fosfomycin resistance genes in staphylococci.Nature communications · 2026Article
- Of Commensals and Opportunists: Genomics of Coagulase-Negative Staphylococci During Sequential Ear and Eye Infections in a Healthy Adult.MicrobiologyOpen · 2026Article
- Sub-inhibitory concentrations of fosfomycin enhanceMicrobiology spectrum · 2025Article
- Article
- Small regulatory RNA RSaX28 promotes virulence by reinforcing the stability of RNAIII in community-associated ST398 clonotypeEmerging microbes & infections · 2024Article
- Genetic Complexity of CC5Pathogens (Basel, Switzerland) · 2024Article
- Global genetic diversity and Asian clades evolution: a phylogeographic study ofAntimicrobial agents and chemotherapy · 2024Article
- Genomic characterization and outbreak investigations of methicillin-resistantFrontiers in microbiology · 2024Article
- Characteristics of Virulent ST5-SCCInfection and drug resistance · 2023Article
- Comparative genomic analysis of antibiotic resistance and virulence genes inFrontiers in cellular and infection microbiology · 2023Article
- Molecular Basis of Non-β-Lactam Antibiotics Resistance inAntibiotics (Basel, Switzerland) · 2022Review
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10 authors at 1 institution in 1 country.
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Abstract
objectivesFosfomycin resistance has become a clinical concern. In this study, we analysed the dynamic change of fosfomycin MIC in the epidemic Staphylococcus aureus lineages in a teaching hospital in Shanghai for 12 years and sought to elucidate the major underlying mechanisms.
methodsMLST was conducted for 4580 S. aureus isolates recovered from 2008 to 2019. Fosfomycin MIC was determined by the agar dilution method. The genome data of 230 S. aureus epidemic lineage isolates were acquired from a next-generation sequencing (NGS) platform. Gene deletion and corresponding complementation mutants were constructed to confirm the mechanism of fosfomycin resistance.
resultsThe predominant S. aureus lineages during the past 12 years were ST5 and ST239 (45.6%; 2090/4580). However, ST5 has been spreading clinically, while ST239 has gradually disappeared recently. Consistent with epidemic trends, fosfomycin-resistant ST5 increased from 19.5% to 67.3%. Most fosfomycin-resistant ST5 isolates (92.7%; 647/698) possessed high-level resistance (MIC > 1024 mg/L) with combined mutations mainly in glpT and uhpT. In contrast, fosfomycin-resistant ST239 isolates (76.8%; 149/194) mainly acquired low-level resistance (MIC = 64-128 mg/L) with mutation primarily in hptA. Deletion of a single resistant gene merely resulted in low-level fosfomycin resistance, while double-gene mutants ΔglpTΔuhpT, ΔglpTΔhptA and ΔglpTΔhptR acquired high-level fosfomycin resistance.
conclusionsThe high-level fosfomycin resistance of S. aureus epidemic lineage ST5 is mainly due to the accumulation of mutations in the resistant genes related to membrane transporter systems, and partly contributes to its persistent prevalence under clinical antibiotic pressure.
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