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Genetic and molecular predictors of high vancomycin MIC in Staphylococcus aureus bacteremia isolates


Holmes, NE and Turndige, JD and Munckhof, WJ and Robinson, JO and Korman, TM and O'Sullivan, MVN and Anderson, TL and Roberts, SA and Warren, SJC and Coombs, GW and Tan, H-L and Gao, W and Johnson, PDR and Howden, BP, Genetic and molecular predictors of high vancomycin MIC in Staphylococcus aureus bacteremia isolates, Journal of Clinical Microbiology, 52, (9) pp. 3384-3393. ISSN 0095-1137 (2014) [Refereed Article]

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Copyright 2014 American Society for Microbiology

DOI: doi:10.1128/JCM.01320-14


An elevated vancomycin MIC is associated with poor outcomes in Staphylococcus aureus bacteremia (SAB) and is reported in patients with methicillin-susceptible S. aureus (MSSA) bacteremia in the absence of vancomycin treatment. Here, using DNA microarray and phenotype analysis, we investigated the genetic predictors and accessory gene regulator (agr) function and their relationship with elevated vancomycin MIC using blood culture isolates from a multicenter binational cohort of patients with SAB. Specific clonal complexes were associated with elevated (clonal complex 8 [CC8] [P = 0.001]) or low (CC22 [P = 0.001], CC88 [P = 0.001], and CC188 [P = 0.002]) vancomycin MIC. agr dysfunction (P = 0.014) or agr genotype II (P = 0.043) were also associated with an elevated vancomycin MIC. Specific resistance and virulence genes were also linked to an elevated vancomycin MIC, including blaZ (P = 0.002), sea (P = 0.001), clfA (P = 0.001), splA (P = 0.001), and the arginine catabolic mobile element (ACME) locus (P = 0.02). These data suggest that inherent organism characteristics may explain the link between elevated vancomycin MICs and poor outcomes in patients with SAB, regardless of the antibiotic treatment received. A consideration of clonal specificity should be included in future research when attempting to ascertain treatment effects or clinical outcomes.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Infectious diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Anderson, TL (Dr Tara Anderson)
ID Code:98275
Year Published:2014
Web of Science® Times Cited:30
Deposited By:Medicine
Deposited On:2015-02-10
Last Modified:2017-09-04

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