Inducible clindamycin resistance and molecular epidemiologic trends of pediatric community-acquired methicillin-resistant Staphylococcus aureus in Dallas, Texas

Susana Chavez-Bueno, Bülent Bozdogan, Kathy Katz, Karen L. Bowlware, Nancy Cushion, Dominick Cavuoti, Naveed Ahmad, George H. McCracken, Peter C. Appelbaum

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Abstract

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection occurs commonly in children. Clindamycin resistance may be inducible or constitutive, and the rates of inducible resistance in CA-MRSA that could produce clindamycin treatment failures vary worldwide. The double-disk test was performed in 197 erythromycin-resistant and clindamycin-susceptible CA-MRSA strains from children in Dallas, Texas, from 1999 to 2002 to determine inducible clindamycin resistance. Resistance mechanisms were studied by PCR; epidemiologic trends were studied by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Inducible resistance was demonstrated in 28 (93% ±6%) of 30 tested isolates in 1999, 21 (64%, ±11%) of 33 in 2000, 12 (23% ±7%) of 52 in 2001, and 6 (7% ± 3%) of 82 in 2002. All noninducible strains had the msr(A) gene. Among inducible resistant strains, 31 had erm(B), 24 had erm(C), and 12 had erm(A) genes. Two distinct pulsed types were the most prevalent; one of them was the most common pulsed type in 1999, whereas in 2002 a different pulsed type was prevalent. MLST analyses determined that ST-8 was the most common type, with 76% ±5% found in 2002. All but one of these clindamycin-susceptible, erythromycin-resistant ST-8 strains showed no induction of clindamycin resistance. We conclude that, among erythromycin-resistant, clindamycin-susceptible CA-MRSA strains isolated from children in Dallas, inducible methylase resistance became less common from 1999 to 2002 (P < 0.001). The phenotype of strains was associated with their sequence type. Our results demonstrate a clonal shift in CA-MRSA in Dallas children from 1999 to 2002.

Original languageEnglish (US)
Pages (from-to)2283-2288
Number of pages6
JournalAntimicrobial Agents and Chemotherapy
Volume49
Issue number6
DOIs
StatePublished - Jun 2005

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Clindamycin
Methicillin-Resistant Staphylococcus aureus
Pediatrics
Multilocus Sequence Typing
Erythromycin
Pulsed Field Gel Electrophoresis
Treatment Failure
Genes
Phenotype
Polymerase Chain Reaction
Infection

ASJC Scopus subject areas

  • Pharmacology (medical)

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Inducible clindamycin resistance and molecular epidemiologic trends of pediatric community-acquired methicillin-resistant Staphylococcus aureus in Dallas, Texas. / Chavez-Bueno, Susana; Bozdogan, Bülent; Katz, Kathy; Bowlware, Karen L.; Cushion, Nancy; Cavuoti, Dominick; Ahmad, Naveed; McCracken, George H.; Appelbaum, Peter C.

In: Antimicrobial Agents and Chemotherapy, Vol. 49, No. 6, 06.2005, p. 2283-2288.

Research output: Contribution to journalArticle

Chavez-Bueno, Susana ; Bozdogan, Bülent ; Katz, Kathy ; Bowlware, Karen L. ; Cushion, Nancy ; Cavuoti, Dominick ; Ahmad, Naveed ; McCracken, George H. ; Appelbaum, Peter C. / Inducible clindamycin resistance and molecular epidemiologic trends of pediatric community-acquired methicillin-resistant Staphylococcus aureus in Dallas, Texas. In: Antimicrobial Agents and Chemotherapy. 2005 ; Vol. 49, No. 6. pp. 2283-2288.
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