Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp

The National Reference Centre for Staphylococci and Enterococci in Germany has received an increasing number of clinical linezolid-resistant E. faecium isolates in recent years. Five isolates harbored a cfr(B) variant gene locus the product of which is capable of conferring linezolid resistance. The...

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Main Authors: Bender, J, Fleige, C, Klare, I, Fiedler, S, Mischnik, A, Mutters, N, Dingle, K, Werner, G
Format: Journal article
Language:English
Published: Public Library of Science 2016
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author Bender, J
Fleige, C
Klare, I
Fiedler, S
Mischnik, A
Mutters, N
Dingle, K
Werner, G
author_facet Bender, J
Fleige, C
Klare, I
Fiedler, S
Mischnik, A
Mutters, N
Dingle, K
Werner, G
author_sort Bender, J
collection OXFORD
description The National Reference Centre for Staphylococci and Enterococci in Germany has received an increasing number of clinical linezolid-resistant E. faecium isolates in recent years. Five isolates harbored a cfr(B) variant gene locus the product of which is capable of conferring linezolid resistance. The cfr(B)-like methyltransferase gene was also detected in Clostridium difficile. Antimicrobial susceptibility was determined for cfr(B)-positive and linezolid-resistant E. faecium isolates and two isogenic C. difficile strains. All strains were subjected to whole genome sequencing and analyzed with respect to mutations in the 23S rDNA, rplC, rplD and rplV genes and integration sites of the cfr(B) variant locus. To evaluate methyltransferase function, the cfr(B) variant of Enterococcus and Clostridium was expressed in both E. coli and Enterococcus spp. Ribosomal target site mutations were detected in E. faecium strains but absent in clostridia. Sequencing revealed 99.9% identity between cfr(B) of Enterococcus and cfr of Clostridium. The methyltransferase gene is encoded by transposon Tn6218 which was present in C. difficile Ox3196, truncated in some E. faecium and absent in C. difficile Ox3206. The latter finding explains the lack of linezolid and chloramphenicol resistance in C. difficile Ox3206 and demonstrates for the first time a direct correlation of elevated linezolid MICs in C. difficile upon cfr acquisition. Tn6218 insertion sites revealed novel target loci for integration, both within the bacterial chromosome and as an integral part of plasmids. Importantly, the very first plasmid-association of a cfr(B) variant was observed. Although we failed to measure cfr(B)-mediated resistance in transformed laboratory strains the occurrence of the multidrug resistance gene cfr on putatively highly mobile and/or extrachromosomal DNA in clinical isolates is worrisome with respect to dissemination of antibiotic resistances.
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spelling oxford-uuid:11b3737d-b3de-46f3-ab18-27fa5ee40cc62022-03-26T10:03:46ZDetection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus sppJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:11b3737d-b3de-46f3-ab18-27fa5ee40cc6EnglishSymplectic Elements at OxfordPublic Library of Science2016Bender, JFleige, CKlare, IFiedler, SMischnik, AMutters, NDingle, KWerner, GThe National Reference Centre for Staphylococci and Enterococci in Germany has received an increasing number of clinical linezolid-resistant E. faecium isolates in recent years. Five isolates harbored a cfr(B) variant gene locus the product of which is capable of conferring linezolid resistance. The cfr(B)-like methyltransferase gene was also detected in Clostridium difficile. Antimicrobial susceptibility was determined for cfr(B)-positive and linezolid-resistant E. faecium isolates and two isogenic C. difficile strains. All strains were subjected to whole genome sequencing and analyzed with respect to mutations in the 23S rDNA, rplC, rplD and rplV genes and integration sites of the cfr(B) variant locus. To evaluate methyltransferase function, the cfr(B) variant of Enterococcus and Clostridium was expressed in both E. coli and Enterococcus spp. Ribosomal target site mutations were detected in E. faecium strains but absent in clostridia. Sequencing revealed 99.9% identity between cfr(B) of Enterococcus and cfr of Clostridium. The methyltransferase gene is encoded by transposon Tn6218 which was present in C. difficile Ox3196, truncated in some E. faecium and absent in C. difficile Ox3206. The latter finding explains the lack of linezolid and chloramphenicol resistance in C. difficile Ox3206 and demonstrates for the first time a direct correlation of elevated linezolid MICs in C. difficile upon cfr acquisition. Tn6218 insertion sites revealed novel target loci for integration, both within the bacterial chromosome and as an integral part of plasmids. Importantly, the very first plasmid-association of a cfr(B) variant was observed. Although we failed to measure cfr(B)-mediated resistance in transformed laboratory strains the occurrence of the multidrug resistance gene cfr on putatively highly mobile and/or extrachromosomal DNA in clinical isolates is worrisome with respect to dissemination of antibiotic resistances.
spellingShingle Bender, J
Fleige, C
Klare, I
Fiedler, S
Mischnik, A
Mutters, N
Dingle, K
Werner, G
Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp
title Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp
title_full Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp
title_fullStr Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp
title_full_unstemmed Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp
title_short Detection of a cfr(B) variant in German Enterococcus faecium clinical isolates and the impact on Linezolid resistance in Enterococcus spp
title_sort detection of a cfr b variant in german enterococcus faecium clinical isolates and the impact on linezolid resistance in enterococcus spp
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