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Role of <i>parC</i> Mutations at Position 84 on High-Level Delafloxacin Resistance in Methicillin-Resistant <i>Staphylococcus aureus</i>
oleh: Silvia Bolaños, Cesar Acebes, Óscar Martínez-Expósito, José Antonio Boga, Javier Fernández, Carlos Rodríguez-Lucas
Format: | Article |
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Diterbitkan: | MDPI AG 2024-07-01 |
Deskripsi
High-level delafloxacin-resistant (H-L DLX-R) <i>Staphylococcus aureus</i> isolates (minimum inhibitory concentration ≥1 mg/L) associated with mutations affecting position 84 of ParC have emerged. We aimed to elucidate the role of these mutations as a mechanism of H-L DLX resistance in methicillin-resistant <i>S. aureus</i> (MRSA) isolates recovered from blood cultures. Susceptibility to DLX was determined in 75 MRSA isolates by E-test, and an rt-PCR was developed to detect mutations affecting position 84 of ParC to screen a further 185 MRSA isolates. The genomes of 48 isolates, including all DLX-R isolates or with alterations at position 84, and also a subset of DLX-susceptible isolates were analyzed. Among the 75 isolates studied, 77.34% were DLX-susceptible and only 4 H-L DLX-R isolates were found. Seven (3.8%) isolates with alterations at position 84 of ParC were detected by rt-PCR. Genomic analysis showed that 89.9% (8/9) of isolates with the substitution E84K/G in ParC, together with other mutations in <i>gyrA</i> and <i>parC</i>, were H-L DLX-R. However, the E84K substitution in ParC alone or with other alterations was found in two isolates without H-L DLX-R. Alterations at position 84 of ParC are rare but play a key role in H-L DLX resistance in MRSA but only when other alterations in GyrA are present.