Staphylococcus aureus accessory gene regulator (agr) group II: Is there a relationship to the development of intermediate-level glycopeptide resistance?

George Sakoulas*, George M. Eliopoulos, Robert C. Moellering, Richard P. Novick, Lata Venkataraman, Christine Wennersten, Paola C. DeGirolami, Mitchell J. Schwaber, Howard S. Gold

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We previously determined that all 6 Staphylococcus aureus strains with confirmed intermediate-level resistance to glycopeptides (glycopeptide intermediate S. aureus [GISA]) from the United States that we tested belonged to accessory gene regulator (agr) group II. In the present study, we found that 56% of surveyed bloodstream methicillin-resistant S. aureus isolates (n = 148) at our hospital were agr group II, whereas only 24% of methicillin-susceptible S. aureus isolates (n = 33) were agr group II (P = .001). Population analysis of genetically engineered agr-null and parent wild-type strains of groups I, II, and IV revealed that, when agr function is lost, the agr group II knockout S. aureus was most likely to develop glycopeptide heteroresistance after growth in 1 μg/mL but not 16 μg/mL vancomycin. This strain was unique in showing decreased autolysis after growth in these conditions. This study suggests that some S. aureus strains have an intrinsic survival advantage under a glycopeptide selective pressure, which is possibly related to reduced autolysis after exposure to subinhibitory concentrations of glycopeptide.

Original languageEnglish
Pages (from-to)929-938
Number of pages10
JournalJournal of Infectious Diseases
Volume187
Issue number6
DOIs
StatePublished - 15 Mar 2003
Externally publishedYes

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