High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.

Heteroresistance (HR) is an enigmatic phenotype where, in a main population of susceptible cells, small subpopulations of resistant cells exist. This is a cause for concern, as this small subpopulation is difficult to detect by standard antibiotic susceptibility tests, and upon antibiotic exposure t...

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Main Authors: Sheida Heidarian, Andrei Guliaev, Hervé Nicoloff, Karin Hjort, Dan I Andersson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS Biology
Online Access:https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3002457&type=printable
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author Sheida Heidarian
Andrei Guliaev
Hervé Nicoloff
Karin Hjort
Dan I Andersson
author_facet Sheida Heidarian
Andrei Guliaev
Hervé Nicoloff
Karin Hjort
Dan I Andersson
author_sort Sheida Heidarian
collection DOAJ
description Heteroresistance (HR) is an enigmatic phenotype where, in a main population of susceptible cells, small subpopulations of resistant cells exist. This is a cause for concern, as this small subpopulation is difficult to detect by standard antibiotic susceptibility tests, and upon antibiotic exposure the resistant subpopulation may increase in frequency and potentially lead to treatment complications or failure. Here, we determined the prevalence and mechanisms of HR for 40 clinical Staphylococcus aureus isolates, against 6 clinically important antibiotics: daptomycin, gentamicin, linezolid, oxacillin, teicoplanin, and vancomycin. High frequencies of HR were observed for gentamicin (69.2%), oxacillin (27%), daptomycin (25.6%), and teicoplanin (15.4%) while none of the isolates showed HR toward linezolid or vancomycin. Point mutations in various chromosomal core genes, including those involved in membrane and peptidoglycan/teichoic acid biosynthesis and transport, tRNA charging, menaquinone and chorismite biosynthesis and cyclic-di-AMP biosynthesis, were the mechanisms responsible for generating the resistant subpopulations. This finding is in contrast to gram-negative bacteria, where increased copy number of bona fide resistance genes via tandem gene amplification is the most prevalent mechanism. This difference can be explained by the observation that S. aureus has a low content of resistance genes and absence of the repeat sequences that allow tandem gene amplification of these genes as compared to gram-negative species.
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spelling doaj.art-01557c1160304425a314c72a7e9c63bf2024-02-13T05:30:48ZengPublic Library of Science (PLoS)PLoS Biology1544-91731545-78852024-01-01221e300245710.1371/journal.pbio.3002457High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.Sheida HeidarianAndrei GuliaevHervé NicoloffKarin HjortDan I AnderssonHeteroresistance (HR) is an enigmatic phenotype where, in a main population of susceptible cells, small subpopulations of resistant cells exist. This is a cause for concern, as this small subpopulation is difficult to detect by standard antibiotic susceptibility tests, and upon antibiotic exposure the resistant subpopulation may increase in frequency and potentially lead to treatment complications or failure. Here, we determined the prevalence and mechanisms of HR for 40 clinical Staphylococcus aureus isolates, against 6 clinically important antibiotics: daptomycin, gentamicin, linezolid, oxacillin, teicoplanin, and vancomycin. High frequencies of HR were observed for gentamicin (69.2%), oxacillin (27%), daptomycin (25.6%), and teicoplanin (15.4%) while none of the isolates showed HR toward linezolid or vancomycin. Point mutations in various chromosomal core genes, including those involved in membrane and peptidoglycan/teichoic acid biosynthesis and transport, tRNA charging, menaquinone and chorismite biosynthesis and cyclic-di-AMP biosynthesis, were the mechanisms responsible for generating the resistant subpopulations. This finding is in contrast to gram-negative bacteria, where increased copy number of bona fide resistance genes via tandem gene amplification is the most prevalent mechanism. This difference can be explained by the observation that S. aureus has a low content of resistance genes and absence of the repeat sequences that allow tandem gene amplification of these genes as compared to gram-negative species.https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3002457&type=printable
spellingShingle Sheida Heidarian
Andrei Guliaev
Hervé Nicoloff
Karin Hjort
Dan I Andersson
High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.
PLoS Biology
title High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.
title_full High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.
title_fullStr High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.
title_full_unstemmed High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.
title_short High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.
title_sort high prevalence of heteroresistance in staphylococcus aureus is caused by a multitude of mutations in core genes
url https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3002457&type=printable
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AT hervenicoloff highprevalenceofheteroresistanceinstaphylococcusaureusiscausedbyamultitudeofmutationsincoregenes
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