Abstract
We analyzed the occurrence and mechanisms of fusidic acid resistance present in staphylococci isolated from 59 healthy volunteers. The fingers of the volunteers were screened for the presence of staphylococci, and the collected isolates were tested for resistance to fusidic acid. A total of 34 fusidic acid resistant staphylococcal strains (all were coagulase-negative) were isolated from 22 individuals (22/59, 37.3%). Examination of the resistance genes revealed that acquired fusB or fusC was present in Staphylococcus epidermidis, Staphylococcus capitis subsp. urealyticus, Staphylococcus hominis subsp. hominis, Staphylococcus warneri and Staphylococcus haemolyticus. Resistance islands (RIs) carrying fusB were found in S. epidermidis and S. capitis subsp. urealyticus, while staphylococcal chromosome cassette (SCC)-related structures harboring fusC were found in S. hominis subsp. hominis. Genotypic analysis of S. epidermidis and S. hominis subsp. hominis indicated that the fus elements were disseminated in diverse genetic strain backgrounds. The fusC elements in S. hominis subsp. hominis strains were highly homologous to SCCfusC in the epidemic sequence type (ST) 239/SCCmecIII methicillin-resistant S. aureus (MRSA) or the pseudo SCCmec in ST779 MRSA. The presence of acquired fusidic acid resistance genes and their genetic environment in commensal staphylococci suggested that the skin commensal staphylococci may act as reservoir for fusidic acid resistance genes.
Highlights
Fusidic acid is a steroid antibiotic that is used to treat skin infections caused by staphylococci in some countries [1]
Among the 853 isolates collected from 59 volunteers, a total of 70 isolates recovered from 22 individuals (22/59 = 37.3%) were found to be fusidic acid-resistant staphylococci (MIC values ≧ 2 μg/ml)
Three S. capitis subsp. urealyticus strains isolated from three different individuals were phylogenetically related because the DNA restriction patterns produced by Pulsed-field gel electrophoresis (PFGE) had less than two-band differences
Summary
Fusidic acid is a steroid antibiotic that is used to treat skin infections caused by staphylococci in some countries [1]. The major target of fusidic acid is elongation factor G (EF-G), which is involved in protein synthesis [2,3,4]. Two major mechanisms of fusidic acid resistance have been reported. One mechanism is alteration of the drug target site, which is due to mutations in fusA (encoding EF-G) or fusE (encoding ribosome protein L6) [2, 5, 6]. PLOS ONE | DOI:10.1371/journal.pone.0143106 November 18, 2015
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