Genetic Basis of Emerging Vancomycin, Linezolid, and Daptomycin Heteroresistance in a Case of Persistent Enterococcus faecium Bacteremia

Whole-genome sequencing was used to examine a persistent bacteremia that acquired heteroresistance to three antibiotics in response to prolonged multidrug therapy. A comparison of the complete genomes before and after each change revealed the emergence of known resistance determinants for vancomycin...

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Bibliographic Details
Published in:Antimicrobial agents and chemotherapy 2018-04, Vol.62 (4)
Main Authors: Chacko, Kieran I, Sullivan, Mitchell J, Beckford, Colleen, Altman, Deena R, Ciferri, Brianne, Pak, Theodore R, Sebra, Robert, Kasarskis, Andrew, Hamula, Camille L, van Bakel, Harm
Format: Article
Language:English
Subjects:
Bacteremia
Daptomycin
Enterococcus faecium
Linezolid
Mechanisms of Resistance
Vancomycin
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Summary:Whole-genome sequencing was used to examine a persistent bacteremia that acquired heteroresistance to three antibiotics in response to prolonged multidrug therapy. A comparison of the complete genomes before and after each change revealed the emergence of known resistance determinants for vancomycin and linezolid and suggested that a novel mutation in , encoding a fatty acid synthase, was responsible for daptomycin nonsusceptibility. Plasmid recombination contributed to the progressive loss of vancomycin resistance after withdrawal of the drug.
ISSN:0066-4804
1098-6596
DOI:10.1128/AAC.02007-17