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CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(02): 207-211
DOI: 10.1055/s-0042-1757419
Original Article

Detection of a Novel G2603T Mutation in cfr Harboring Linezolid-Resistant Staphylococcus haemolyticus: First Report from India

Rhea Michelle J. Khodabux
1   Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai, Tamil Nadu, India
,
Shanthi Mariappan
1   Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai, Tamil Nadu, India
,
Uma Sekar
1   Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai, Tamil Nadu, India
› Author Affiliations Funding This study was supported by the Founder chancellor Shri N.P.V. Ramasamy Udayar fellowship, provided by Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
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Abstract

Background Staphylococcus haemolyticus has emerged as an important multidrug-resistant nosocomial pathogen. Linezolid is useful in the treatment of severe infections caused by methicillin-resistant Staphylococci. Resistance to linezolid in Staphylococci is due to one or more of the following mechanisms: acquisition of the cfr (chloramphenicol florfenicol resistance) gene, mutation in the central loop of domain V of the 23S rRNA, and mutation in the rplC and rplD genes. This study was carried out to detect and characterize resistance to linezolid among the clinical isolates of Staphylococcus haemolyticus.

Materials and Methods The study included 84 clinical isolates of Staphylococcus haemolyticus. Susceptibility to various antibiotics was determined by disc diffusion method. Minimum inhibitory concentration (MIC) was determined by agar dilution method for linezolid. Methicillin resistance was screened using oxacillin and cefoxitin disc. Polymerase chain reaction was done to detect mecA, cfr and mutations in the V domain of the 23S rRNA gene.

Results Resistance to linezolid was exhibited by 3 of the 84 study isolates with MIC more than 128 µg/mL. The cfr gene was detected in all the three isolates. The G2603T mutation was observed in the domain V of the 23S rRNA among two isolates, whereas one isolate lacked any mutation.

Conclusion The emergence and spread of linezolid-resistant Staphylococcus haemolyticus isolates carrying G2603T mutation in the domain V of the 23S rRNA and harboring the cfr gene pose a threat in clinical practice.

Keywords

linezolid resistance - cfr gene - 23S rRNA gene - Staphylococcus haemolyticus


Publication History

Article published online:
20 October 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Becker K, Heilmann C, Peters G. Coagulase-negative staphylococci. Clin Microbiol Rev 2014; 27 (04) 870-926
    CrossrefPubMedGoogle Scholar
  • 2 Michalik M, Kosecka-Strojek M, Wolska M, Samet A, Podbielska-Kubera A, Międzobrodzki J. First case of staphylococci carrying linezolid resistance genes from laryngological infections in Poland. Pathogens 2021; 10 (03) 335
    CrossrefPubMedGoogle Scholar
  • 3 Manoharan M, Sistla S, Ray P. Prevalence and molecular determinants of antimicrobial resistance in clinical isolates of Staphylococcus haemolyticus from India. Microb Drug Resist 2021; 27 (04) 501-508
    CrossrefPubMedGoogle Scholar
  • 4 Zhou W, Niu D, Cao X. et al. Clonal dissemination of linezolid-resistant Staphylococcus capitis with G2603T mutation in domain V of the 23S rRNA and the cfr gene at a tertiary care hospital in China. BMC Infect Dis 2015; 15: 97
    CrossrefPubMedGoogle Scholar
  • 5 Quiles-Melero I, Gómez-Gil R, Romero-Gómez MP. et al. Mechanisms of linezolid resistance among Staphylococci in a tertiary hospital. J Clin Microbiol 2013; 51 (03) 998-1001
    CrossrefPubMedGoogle Scholar
  • 6 Rajan V, Kumar VG, Gopal S. A cfr-positive clinical staphylococcal isolate from India with multiple mechanisms of linezolid-resistance. Indian J Med Res 2014; 139 (03) 463-467
    PubMedGoogle Scholar
  • 7 Tsiodras S, Gold HS, Sakoulas G. et al. Linezolid resistance in a clinical isolate of Staphylococcus aureus. Lancet 2001; 358 (9277): 207-208
    CrossrefPubMedGoogle Scholar
  • 8 Tian Y, Li T, Zhu Y, Wang B, Zou X, Li M. Mechanisms of linezolid resistance in staphylococci and enterococci isolated from two teaching hospitals in Shanghai, China. BMC Microbiol 2014; 14: 292
    CrossrefPubMedGoogle Scholar
  • 9 Stefani S, Bongiorno D, Mongelli G, Campanile F. Linezolid Resistance in Staphylococci. Pharmaceuticals (Basel) 2010; 3 (07) 1988-2006
    CrossrefPubMedGoogle Scholar
  • 10 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: 29th ed. CLSI supplement. Wayne, PA: CLSI; 2019
  • 11 Sasaki T, Tsubakishita S, Tanaka Y. et al. Multiplex-PCR method for species identification of coagulase-positive staphylococci. J Clin Microbiol 2010; 48 (03) 765-769
    CrossrefPubMedGoogle Scholar
  • 12 Bhatt P, Tandel K, Singh A, Kumar M, Grover N, Sahni AK. Prevalence and molecular characterization of methicillin resistance among Coagulase-negative Staphylococci at a tertiary care center. Med J Armed Forces India 2016; 72 (Suppl 1): S54-S58
    CrossrefPubMedGoogle Scholar
  • 13 Mittal G, Bhandari V, Gaind R. et al. Linezolid resistant coagulase negative staphylococci (LRCoNS) with novel mutations causing blood stream infections (BSI) in India. BMC Infect Dis 2019; 19 (01) 717
    CrossrefPubMedGoogle Scholar
  • 14 Nguyen LTT, Nguyen KNT, Le PNTA. et al. The emergence of plasmid-borne cfr-mediated linezolid resistant-staphylococci in Vietnam. J Glob Antimicrob Resist 2020; 22: 462-465
    CrossrefPubMedGoogle Scholar
  • 15 Chamon RC, Iorio NL, Cavalcante FS. et al. Linezolid-resistant Staphylococcus haemolyticus and Staphylococcus hominis: single and double mutations at the domain V of 23S rRNA among isolates from a Rio de Janeiro hospital. Diagn Microbiol Infect Dis 2014; 80 (04) 307-310
    CrossrefPubMedGoogle Scholar
  • 16 Cidral TA, Carvalho MC, Figueiredo AM, de Melo MC. Emergence of methicillin-resistant coagulase-negative staphylococci resistant to linezolid with rRNA gene C2190T and G2603T mutations. APMIS 2015; 123 (10) 867-871
    CrossrefPubMedGoogle Scholar
  • 17 de Almeida LM, Lincopan N, de Araújo MR, Mamizuka EM. Clonal dissemination of linezolid-resistant Staphylococcus haemolyticus exhibiting the G2576T mutation in the 23S rRNA gene in a tertiary care hospital in Brazil. Antimicrob Agents Chemother 2012; 56 (05) 2792-2793
    CrossrefPubMedGoogle Scholar
  • 18 Tewhey R, Gu B, Kelesidis T. et al. Mechanisms of linezolid resistance among coagulase-negative staphylococci determined by whole-genome sequencing. MBio 2014; 5 (03) e00894-e14
    CrossrefPubMedGoogle Scholar
  • 19 Kumari S, Rawre J, Trikha A. et al. Linezolid-resistant Staphylococcus haemolyticus: emergence of G2447U & C2534U mutations at the domain V of 23S ribosomal RNA gene in a tertiary care hospital in India. Indian J Med Res 2019; 149 (06) 795-798
    CrossrefPubMedGoogle Scholar
  • 20 Brijwal M, Dhawan B, Rawre J, Sebastian S, Kapil A. Clonal dissemination of linezolid-resistant Staphylococcus haemolyticus harbouring a G2576T mutation and the cfr gene in an Indian hospital. J Med Microbiol 2016; 65 (07) 698-700
    CrossrefPubMedGoogle Scholar
  • 21 Vijayan P, Srinivas D, Siddaiah N, Bahubali VKH. Device-associated meningitis by linezolid-resistant Staphylococcus haemolyticus in a Vancomycin- hypersensitive patient. J Neurosci Rural Pract 2019; 10 (04) 718-720
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Bakthavatchalam YD, Vasudevan K, Neeravi A, Perumal R, Veeraraghavan B. First draft genome sequence of linezolid and rifampicin resistant Staphylococcus haemolyticus. Jpn J Infect Dis 2020; 73 (04) 296-299
    CrossrefPubMedGoogle Scholar
  • 23 Peer MA, Nasir RA, Kakru DK, Fomda BA, Bashir G, Sheikh IA. Sepsis due to linezolid resistant Staphylococcus cohnii and Staphylococcus kloosii: first reports of linezolid resistance in coagulase negative staphylococci from India. Indian J Med Microbiol 2011; 29 (01) 60-62
    CrossrefPubMedGoogle Scholar
  • 24 Gupta V, Garg S, Jain R, Garg S, Chander J. Linezolid resistant Staphylococcus haemolyticus: first case report from India. Asian Pac J Trop Med 2012; 5 (10) 837-838
    CrossrefPubMedGoogle Scholar