title: Adaptation of methicillin-resistant Staphylococcus aureus during antibiotic therapy.
abstract: Colonization of a patient by methicillin-resistant Staphylococcus aureus (MRSA) of a single phage-type for over four years is described. During this period we observed the appearance and disappearance of resistance to erythromycin, clindamycin, gentamicin, kanamycin, tobramycin, neomycin and mupirocin. We also saw stepwise increases in methicillin resistance and reversible changes in physical appearance and the colonizer pathogen role. Correlation of clinical observations, details of antibiotic therapy and laboratory studies demonstrated that adaptation of MRSA during antibiotic therapy favoured MRSA establishment and predominance.
authors.affiliation: Microbiology Department, Green Lane Hospital, Auckland, New Zealand.
authors.forename: R E
authors.initials: RE
authors.lastname: Menzies
authors.forename: B M
authors.initials: BM
authors.lastname: Cornere
authors.forename: D
authors.initials: D
authors.lastname: MacCulloch
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001434:Bacteriophage Typing; D002648:Child; D005227:Fatty Acids / Q000494:pharmacology; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D016712:Mupirocin; D009154:Mutation; D010403:Penicillin Resistance; D010957:Plasmids; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics*; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D005227:Fatty Acids; D016712:Mupirocin; D001618:beta-Lactamases; D008712:Methicillin