title: Emergence and dissemination of a linezolid-resistant Staphylococcus capitis clone in Europe.
abstract: We investigated the epidemiological, clinical, microbiological and genetic characteristics of linezolid-resistant (LZR) Staphylococcus capitis isolates from French ICUs, and compared them with LZR S. capitis isolates from other European countries.
  
  
  
  All LZR isolates were subjected to antimicrobial susceptibility testing (AST) and the presence of cfr and optrA genes as well as mutations in the 23S rRNA and ribosomal proteins were investigated using specific PCR with sequencing. The genetic relationship between isolates was investigated using PFGE and WGS. Epidemiological data concerning LZR S. capitis were collected retrospectively in French microbiology laboratories.
  
  
  
  Twenty-one LZR isolates were studied: 9 from France, 11 from Greece and 1 from Finland. All were resistant to methicillin and aminoglycosides. In addition, this unusual AST profile was identified in S. capitis isolates from seven French hospitals, and represented up to 12% of the S. capitis isolates in one centre. A G2576T mutation in 23S rRNA was identified in all isolates; cfr and optrA genes were absent. All isolates belonged to the same clone on the basis of their PFGE profiles, whatever their geographical origin. WGS found at most 212 SNPs between core genomes of the LZR isolates.
  
  
  
  We identified and characterized an LZR S. capitis clone disseminated in three European countries, harbouring the same multiple resistance and a G2576T mutation in the 23S rRNA. The possible unrecognized wider distribution of this clone, belonging to a species classically regarded as a low-virulence skin colonizer, is of major concern not least because of the increasing use of oxazolidinones.
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Butin
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.|National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Martins-Simões
authors.affiliation: National Infection Service, Public Health England, Colindale, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Pichon
authors.affiliation: Department of Bacteriology, Centre Hospitalier de la Côte Basque, Bayonne, France.
authors.forename: D
authors.initials: D
authors.lastname: Leyssene
authors.affiliation: Department of Bacteriology, Centre Hospitalier de la Côte Basque, Bayonne, France.
authors.forename: S
authors.initials: S
authors.lastname: Bordes-Couecou
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.|National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France.
authors.forename: H
authors.initials: H
authors.lastname: Meugnier
authors.affiliation: Department of Bacteriology, Hôpital Antoine-Béclère, University Paris Sud, Clamart, France.
authors.forename: C
authors.initials: C
authors.lastname: Rouard
authors.affiliation: Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204, Center for Infection and Immunity of Lille, Lille, F-59000, France.
authors.forename: N
authors.initials: N
authors.lastname: Lemaitre
authors.affiliation: Department of Bacteriology, CHRU de Strasbourg, EA7290 Early Bacterial Virulence, FMTS, Université de Strasbourg, Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Schramm
authors.affiliation: National Infection Service, Public Health England, Colindale, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Kearns
authors.affiliation: National Staphylococcal Reference Laboratory, Department of Microbiology, School of Medicine, University of Patras, Patras, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Spiliopoulou
authors.affiliation: National Institute for Health and Welfare, Turku, Finland.
authors.forename: H-L
authors.initials: HL
authors.lastname: Hyyryläinen
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.|National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Dumitrescu
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.|National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Vandenesch
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.|National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Dupieux
authors.affiliation: International Center for Infectiology Research (CIRI), INSERM U1111-CNRS UMR5308-ENS Lyon-University Claude Bernard Lyon 1, France.|Department of Bacteriology, Hospices Civils de Lyon, Lyon, France.|National Reference Center for Staphylococci, Hospices Civils de Lyon, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Laurent
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016000:Cluster Analysis; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005387:Finland / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D005798:Genes, Bacterial; D016680:Genome, Bacterial; D005838:Genotype; D006115:Greece / Q000453:epidemiology; D006801:Humans; D000069349:Linezolid / Q000494:pharmacology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009154:Mutation; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013210:Staphylococcus / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D012338:RNA, Ribosomal, 23S; D000069349:Linezolid