Transferable Vancomycin Resistance in a Community-Associated MRSA Lineage
Open accessAbstract
We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A recent report described the vanA gene cluster harbored in a highly transferable staphylococcal plasmid originally identified in community-associated S. aureus isolates, in a bloodstream MRSA isolate from a Brazilian patient, with transfer to a methicillin-susceptible isolate within the same patient documented.
“Indeed, a recent report described such phenomenon where the vanA gene cluster was harbored in a highly transferable staphylococcal plasmid originally identified in community-associated S. aureus isolates. The isolate was found in a bloodstream isolate of MRSA recovered from a Brazilian patient (80) and transfer to a methicillin-susceptible isolate within the same patient was also documented.”
From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [80]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diep, B. A., Gill, S. R., Chang, R. F., Phan, T. H., Chen, J. H., Davidson, M. G., Lin, F., Lin, J., Carleton, H. A., Mongodin, E. F., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68231-7 · Cited by 1,633 · see citing works
Community-associated meticillin-resistant Staphylococcus aureus
DeLeo, F. R., Otto, M. J., Kreiswirth, B. N., & Chambers, H. F. “. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61999-1 · Cited by 1,502 · see citing works
Dutka‐Malen, S., Evers, S., & Courvalin, P. M. (1995) · Journal of Clinical Microbiology · doi:10.1128/jcm.33.1.24-27.1995 · Cited by 1,406 · see citing works
Chang, S., Sievert, D. M., Hageman, J. C., Boulton, M. L., Tenover, F. C., Downes, F. P., Shah, S., Rudrik, J. T., Pupp, G. R., Brown, W. J., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa025025 · Cited by 1,095 · see citing works
Genetic Analysis of a High-Level Vancomycin-Resistant Isolate of Staphylococcus aureus
Weigel, L. M., Clewell, D. B., Gill, S. R., Clark, N. C., McDougal, L. K., Flannagan, S. E., Kolonay, J. F., Shetty, J., Killgore, G., & Tenover, F. C. (2003) · Science · doi:10.1126/science.1090956 · Cited by 889 · see citing works
A General Method for Detecting and Sizing Large Plasmids
Barton, B. M., Harding, G., & Zuccarelli, A. J. (1995) · Analytical Biochemistry · doi:10.1006/abio.1995.1220 · Cited by 702 · see citing works
Arthur, M., Molinas, C., Depardieu, F., & Courvalin, P. M. (1993) · Journal of Bacteriology · doi:10.1128/jb.175.1.117-127.1993 · Cited by 600 · see citing works
Martineau, F., Picard, F. J., Lansac, N., et al. (2000) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.44.2.231-238.2000 · Cited by 425 · see citing works
Genetic Basis for In Vivo Daptomycin Resistance in Enterococci
Arias, C. A., Panesso, D., McGrath, D. M., Qin, X., Mojica, M. F., Miller, C., Diaz, L., Tran, T. T., Rincon, S., Barbu, E. M., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1011138 · Cited by 377 · see citing works
Self-citationDutka‐Malen, S., Evers, S., & Courvalin, P. M. (1995) · Journal of Clinical Microbiology · doi:10.1128/jcm.33.5.1434-1434.1995 · Cited by 255 · see citing works
Saha, B., Singh, A. K., Ghosh, A., & Bal, M. (2007) · Journal of Medical Microbiology · doi:10.1099/jmm.0.47144-0 · Cited by 195 · see citing works
McCarthy, A. J., & Lindsay, J. A. (2012) · BMC Microbiology · doi:10.1186/1471-2180-12-104 · Cited by 165 · see citing works
Azimian, A., Havaei, S. A., Fazeli, H., Naderi, M., Ghazvini, K., Samiee, S. M., Soleimani, M., & Peerayeh, S. N. (2012) · Journal of Clinical Microbiology · doi:10.1128/jcm.01727-12 · Cited by 154 · see citing works
Reyes, J., Rincón, S., Díaz, L., Panesso, D., Contreras, G., Zurita, J., Carrillo, C., Rizzi, A., Guzmán, M., Adachi, J. A., et al. (2009) · Clinical Infectious Diseases · doi:10.1086/648426 · Cited by 151 · see citing works
Self-citationKos, V. N., Desjardins, C. A., Griggs, A. D., Cerqueira, G., van Tonder, A. J., Holden, M. T. G., Godfrey, P. A., Palmer, K. L., Bodi, K. L., Mongodin, E. F., et al. (2012) · mBio · doi:10.1128/mbio.00112-12 · Cited by 148 · see citing works
Evolution of methicillin-resistant Staphylococcus aureus clones in Latin America
Rodríguez-Noriega, E., Seas, C., Guzmán-Blanco, M., Mejía, C., Álvarez, C., Luis Bavestrello, F., Zurita, J., Labarca, J. A., Luna, C. M., Salles, M. J. C., et al. (2010) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2009.08.018 · Cited by 133 · see citing works
Zhu, W., Murray, P. R., Huskins, W. C., Jernigan, J. A., McDonald, L. C., Clark, N. C., Anderson, K. F., McDougal, L. K., Hageman, J., Olsen-Rasmussen, M. A., et al. (2010) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00185-10 · Cited by 126 · see citing works
Report of the 13th Vancomycin-Resistant Staphylococcus aureus Isolate from the United States
Limbago, B. M., Kallen, A. J., Zhu, W., Eggers, P. C., McDougal, L. K., & Albrecht, V. S. (2013) · Journal of Clinical Microbiology · doi:10.1128/jcm.02187-13 · Cited by 124 · see citing works
Tomita, H., Pierson, C. L., Lim, S. K., et al. (2002) · Journal of Clinical Microbiology · doi:10.1128/jcm.40.9.3326-3333.2002 · Cited by 98 · see citing works
Arias, C. A., Panesso, D., Singh, K. V., Rice, L. B., & Murray, B. E. (2009) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00242-09 · Cited by 79 · see citing works
Self-citationZhu, W., Clark, N. C., & Patel, J. B. (2012) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01587-12 · Cited by 76 · see citing works
MRSA USA300 Clone and VREF — A U.S.–Colombian Connection?
Arias, C. A., Rincón, S., Chowdhury, S. A., Martínez, E., Coronell-Rodríguez, W., Reyes, J., Nallapareddy, S. R., & Murray, B. E. (2008) · New England Journal of Medicine · doi:10.1056/nejmc0804021 · Cited by 68 · see citing works
Self-citationCC8 MRSA Strains Harboring SCCmec Type IVc are Predominant in Colombian Hospitals
Jiménez, J. N., Ocampo, A. M., Vanegas, J. M., Rodríguez, E. A., Mediavilla, J. R., Chen, L., Muskus, C., Vélez, L. A., Rojas, C. A., Restrepo, A., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0038576 · Cited by 67 · see citing works
Woo, P. C. Y. (2001) · Molecular Pathology · doi:10.1136/mp.54.4.244 · Cited by 59 · see citing works
Lozano, C., Migura, L. G., Aspíroz, C., et al. (2012) · Applied and Environmental Microbiology · doi:10.1128/aem.00870-12 · Cited by 54 · see citing works
O’Brien, F. G., Coombs, G. W., Pearman, J. W., Gracey, M. S., Moss, F. L., Christiansen, K., & Grubb, W. B. (2009) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkp285 · Cited by 49 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Mechanisms of Antibiotic Resistance
Munita, J. M., & Arias, C. A. (2016) · Microbiology Spectrum · doi:10.1128/microbiolspec.vmbf-0016-2015 · Cited by 2,782 · see citing works
Self-citationMobile Genetic Elements Associated with Antimicrobial Resistance
Partridge, S. R., Kwong, S. M., Firth, N., & Jensen, S. O. (2018) · Clinical Microbiology Reviews · doi:10.1128/cmr.00088-17 · Cited by 2,751 · see citing works
Mechanisms of antibiotic resistance
Munita, J. M., & Arias, C. A. (2016) · Virulence Mechanisms of Bacterial Pathogens · doi:10.1128/9781555819286.ch17 · Cited by 421 · see citing works
Self-citationRapid Detection of Methicillin-Resistant Staphylococcus aureus in BAL
Paonessa, J. R., Shah, R. D., Pickens, C. I., Lizza, B. D., Donnelly, H. K., Malczynski, M., Qi, C., & Wunderink, R. G. (2019) · Chest · doi:10.1016/j.chest.2019.02.007 · Cited by 66 · see citing works
- Authors
- Rossi, F., Diaz, L., Wollam, A., Panesso, D., Zhou, Y., Rincon, S., Narechania, A., Xing, G., Di Gioia, T. S. R., Doi, A., Tran, T. T., Reyes, J., Munita, J. M., Carvajal, L. P., Hernandez-Roldan, A., Brandão, D., van der Heijden, I. M., Murray, B. E., Planet, P. J., Weinstock, G. M., & Arias, C. A.
- Affiliations
- Universidad del Desarrollo (CL)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2014-04-17
- Volume
- 370
- Issue
- 16
- Pages
- 1524-1531
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC4112484
- OpenAlex
- W2091265623
- Cited by
- 182
- References
- 26
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 12 · 2023: 11 · 2022: 13 · 2021: 16 · 2020: 11 · 2019: 21 · 2018: 12 · 2017: 10 · 2016: 11 · 2015: 28 · 2014: 23 · 2013: 1
- FWCI
- 16.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion)
- Funders
- National Institutes of Health
- National Human Genome Research Institute (U54HG003079, U54HG004968)
- National Institute of Allergy and Infectious Diseases (R01AI093749, K08AI101005)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- vancomycin resistance, methicillin-resistant Staphylococcus aureus, community-acquired MRSA, conjugative plasmids, plasmid transfer, bloodstream infection, USA300, plasmid replication genes, antimicrobial resistance dissemination
- MeSH terms
- Adult, Brazil, Multigene Family, Humans, Male, Microbial Sensitivity Tests, Mycosis Fungoides, Plasmids, Bacteremia, Genome, Bacterial, Sequence Analysis, DNA, Vancomycin Resistance, Gene Transfer, Horizontal, Methicillin-Resistant Staphylococcus aureus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
