Genetic basis of emerging vancomycin, linezolid, and daptomycin heteroresistance in a case of persistent Enterococcus faecium bacteremia.

Authors: Chacko, Kieran I and Sullivan, Mitchell J and Beckford, Colleen and Altman, Deena R and Ciferri, Brianne and Pak, Theodore R and Sebra, Robert and Kasarskis, Andrew and Hamula, Camille L and van Bakel, Harm

Whole-genome sequencing was used to examine a persistent Enterococcus faecium 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 fabF, 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. Copyright © 2018 Chacko et al.

Journal: Antimicrobial agents and chemotherapy
DOI: 10.1128/AAC.02007-17
Year: 2018

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