Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/12178
Title: Tracking changes in the vraSR and graSR two component regulatory systems during the development and loss of vancomycin non-susceptibility in a clinical isolate
Authors: Doddangoudar, VC
Boost, MV
Tsang, DNC
O'Donoghue, MM 
Keywords: Methicillin-resistant Staphylococcus aureus
Treatment failure
Two component regulatory systems
Vancomycin
Vancomycin intermediately-susceptible
Issue Date: 2011
Publisher: Elsevier
Source: Clinical microbiology and infection, 2011, v. 17, no. 8, p. 1268-1272 How to cite?
Journal: Clinical microbiology and infection 
Abstract: We investigated changes in regulatory genes, vraS and graR, during development of vancomycin non-susceptibility in a patient with methicillin-resistant Staphylococcus aureus who failed therapy and following in-vitro vancomycin exposure and a subsequent drug-free growth period. Minimum Inhibitory Concentration (MICs) were determined and genes sequenced at each stage. After 30days of vancomycin exposure, the strain attained maximum MIC (20mg/L) and was resistant to all antibiotics. Reversion to vancomycin susceptibility occurred 21days after removal. We observed mutations in vraS and graR during non-susceptibly development and novel stop codons in the reverted strain. Mutations in graR appear important for development of intermediate susceptibility to vancomycin. The results suggest that monitoring of vancomycin therapy could allow earlier change to appropriate agents.
URI: http://hdl.handle.net/10397/12178
ISSN: 1198-743X
EISSN: 1469-0691
DOI: 10.1111/j.1469-0691.2011.03463.x
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