Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Global spread of three multidrug-resistant lineages of Staphylococcus epidermidis

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Recovery of gut microbiota of healthy adults following antibiotic exposure

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Eradicating MRSA carriage: the impact of throat carriage and Panton-Valentine leukocidin genes on success rates

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. A Sporadic Four-Year Hospital Outbreak of a ST97-IVa MRSA With Half of the Patients First Identified in the Community

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Staphylococcal aureus Enterotoxin C and Enterotoxin-Like L Associated with Post-partum Mastitis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Jean Y H Lee
  • Ian R Monk
  • Anders Gonçalves da Silva
  • Torsten Seemann
  • Kyra Y L Chua
  • Angela Kearns
  • Robert Hill
  • Neil Woodford
  • Mette D Bartels
  • Birgit Strommenger
  • Frederic Laurent
  • Magali Dodémont
  • Ariane Deplano
  • Robin Patel
  • Anders R Larsen
  • Tony M Korman
  • Timothy P Stinear
  • Benjamin P Howden
View graph of relations

Staphylococcus epidermidis is a conspicuous member of the human microbiome, widely present on healthy skin. Here we show that S. epidermidis has also evolved to become a formidable nosocomial pathogen. Using genomics, we reveal that three multidrug-resistant, hospital-adapted lineages of S. epidermidis (two ST2 and one ST23) have emerged in recent decades and spread globally. These lineages are resistant to rifampicin through acquisition of specific rpoB mutations that have become fixed in the populations. Analysis of isolates from 96 institutions in 24 countries identified dual D471E and I527M RpoB substitutions to be the most common cause of rifampicin resistance in S. epidermidis, accounting for 86.6% of mutations. Furthermore, we reveal that the D471E and I527M combination occurs almost exclusively in isolates from the ST2 and ST23 lineages. By breaching lineage-specific DNA methylation restriction modification barriers and then performing site-specific mutagenesis, we show that these rpoB mutations not only confer rifampicin resistance, but also reduce susceptibility to the last-line glycopeptide antibiotics, vancomycin and teicoplanin. Our study has uncovered the previously unrecognized international spread of a near pan-drug-resistant opportunistic pathogen, identifiable by a rifampicin-resistant phenotype. It is possible that hospital practices, such as antibiotic monotherapy utilizing rifampicin-impregnated medical devices, have driven the evolution of this organism, once trivialized as a contaminant, towards potentially incurable infections.

Original languageEnglish
JournalNature Microbiology
Volume3
Pages (from-to)1175-1185
DOIs
Publication statusPublished - 3 Sep 2018

ID: 55128566