JAC Advance Access published online on October 8, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkf191
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Medical Microbiology,
Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN
* Corresponding author. E-mail: f.m.mackenzie{at}abdn.ac.uk.
Received 30 November 2001
; revised 20 March 2002
; accepted 1 August 2002
The study objective was to screen both methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) isolates from blood cultures for
reduced susceptibility to vancomycin and teicoplanin. A total of
72 MRSA and 143 MSSA isolates were screened on brain-heart
infusion agar containing either 4 mg/L vancomycin or 8 mg/L teicoplanin,
using an inoculum of
Identification and characterization of teicoplanin-intermediate Staphylococcus aureus blood culture isolates in
NE Scotland
2 Scottish MRSA Reference Laboratory,
Microbiology Department, Glasgow Royal Infirmary, 84 Castle Street,
Glasgow G4 0SF, UK
106 organisms.
MICs were determined by Etest, broth microdilution and agar incorporation.
Isolates were characterized by PFGE, mecA and nuc PCR, transmission electron microscopy (TEM)
and analysis of cell proteins (proteomics). Based on British Society
for Antimicrobial Chemotherapy (BSAC) breakpoints, seven MRSAs and
seven MSSAs were teicoplanin resistant, with MICs of up to 16 and
24 mg/L respectively, but were vancomycin sensitive. Based on higher
NCCLS breakpoints, five MRSAs and six MSSAs were teicoplanin intermediate, vancomycin
sensitive. All the MRSAs belonged to the EMRSA-16 clone and subdivided
into two groups. The MSSAs belonged to five different clones. TEM
showed the resistant variants to have slightly thicker cell walls
than sensitive variants. Most notably, the resistant variants possessed characteristic
dark, granular material concentrated in the middle of the cells,
believed to be chromosome. Proteomics showed the resistant variants
to overexpress phosphoglycerate kinase. Both MRSA and MSSA with
reduced teicoplanin susceptibility may remain vancomycin sensitive
by NCCLS and BSAC criteria and it is important to screen clinical
isolates of MRSA and MSSA for reduced susceptibility to both agents.
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