Transferable Multidrug Resistance Plasmid CarryingcfrAssociated withtet(L),ant(4′)-Ia, anddfrKGenes from a Clinical Methicillin-Resistant Staphylococcus aureus ST125 Strain

Abstract

ABSTRACTA multidrug resistance (MDR) conjugative plasmid of ca. 50 kb (designated pERGB) was detected in a linezolid and methicillin-resistantStaphylococcus aureusstrain with sequence type 125 (ST125-MRSA-IVc). This strain was detected in two patients with chronic obstructive pulmonary disease, previously treated with multiple antimicrobials, including linezolid. pERGB was transferable by conjugation and carried the resistance genescfr(oxazolidinones, phenicols, lincosamides, pleuromutilins, and streptogramin A),ant(4′)-Ia(tobramycin),tet(L) (tetracycline), anddfrK(trimethoprim). A novel genetic structure, linking all of these resistance genes for the first time, was elucidated through sequencing of a 15,259-bp fragment from pERGB. Active surveillance to prevent the dissemination of such highly concerning MDR transferable elements is needed.