title: In vivo survival of teicoplanin-resistant Staphylococcus aureus and fitness cost of teicoplanin resistance.
abstract: Glycopeptide resistance, in a set of in vitro step-selected teicoplanin-resistant mutants derived from susceptible Staphylococcus aureus SA113, was associated with slower growth, thickening of the bacterial cell wall, increased N-acetylglucosamine incorporation, and decreased hemolysis. Differential transcriptome analysis showed that as resistance increased, some virulence-associated genes became downregulated. In a mouse tissue cage infection model, an inoculum of 10(4) CFU of strain SA113 rapidly produced a high-bacterial-load infection, which triggered MIP-2 release, leukocyte infiltration, and reduced leukocyte viability. In contrast, with the same inoculum of the isogenic glycopeptide-resistant derivative NM67, CFU initially decreased, resulting in the elimination of the mutant in three out of seven cages. In the four cages in which NM67 survived, it partially regained wild-type characteristics, including thinning of the cell wall, reduced N-acetylglucosamine uptake, and increased hemolysis; however, the survivors also became teicoplanin hypersusceptible. The elimination of the teicoplanin-resistant mutants and selection of teicoplanin-hypersusceptible survivors in the tissue cages indicated that glycopeptide resistance imposes a fitness burden on S. aureus and is selected against in vivo, with restoration of fitness incurring the price of resistance loss.
authors.affiliation: Institute of Medical Microbiology, University of Zürich, 8006 Zurich, Switzerland. mccallum@immv.unizh.ch
authors.forename: N
authors.initials: N
authors.lastname: McCallum
authors.forename: H
authors.initials: H
authors.lastname: Karauzum
authors.forename: R
authors.initials: R
authors.lastname: Getzmann
authors.forename: M
authors.initials: M
authors.lastname: Bischoff
authors.forename: P
authors.initials: P
authors.lastname: Majcherczyk
authors.forename: B
authors.initials: B
authors.lastname: Berger-Bächi
authors.forename: R
authors.initials: R
authors.lastname: Landmann
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D024881:Drug Resistance, Bacterial; D015964:Gene Expression Regulation, Bacterial; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008826:Microbial Sensitivity Tests; D009154:Mutation; D020543:Proteome; D013203:Staphylococcal Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development* / Q000472:pathogenicity; D017334:Teicoplanin / Q000494:pharmacology*; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D020543:Proteome; D017334:Teicoplanin