In VitroCross-Resistance to Daptomycin and Host Defense Cationic Antimicrobial Peptides in Clinical Methicillin-Resistant Staphylococcus aureus Isolates

Abstract

ABSTRACTWe investigated the hypothesis that methicillin-resistantStaphylococcus aureus(MRSA) isolates developing reduced susceptibilities to daptomycin (DAP; a calcium-dependent molecule acting as a cationic antimicrobial peptide [CAP]) may also coevolve reducedin vitrosusceptibilities to host defense cationic antimicrobial peptides (HDPs). Ten isogenic pairs of clinical MRSA DAP-susceptible/DAP-resistant (DAPs/DAPr) strains were tested against two distinct HDPs differing in structure, mechanism of action, and origin (thrombin-induced platelet microbicidal proteins [tPMPs] and human neutrophil peptide-1 [hNP-1]) and one bacterium-derived CAP, polymyxin B (PMB). Seven of 10 DAPrstrains had point mutations in themprFlocus (with or withoutyycoperon mutations), while three DAPrstrains had neither mutation. Several phenotypic parameters previously associated with DAPrwere also examined: cell membrane order (fluidity), surface charge, and cell wall thickness profiles. Compared to the 10 DAPsparental strains, their respective DAPrstrains exhibited (i) significantly reduced susceptibility to killing by all three peptides (P< 0.05), (ii) increased cell membrane fluidity, and (iii) significantly thicker cell walls (P< 0.0001). There was no consistent pattern of surface charge profiles distinguishing DAPsand DAPrstrain pairs. Reducedin vitrosusceptibility to two HDPs and one bacterium-derived CAP tracked closely with DAPrin these 10 recent MRSA clinical isolates. These results suggest that adaptive mechanisms involved in the evolution of DAPralso provide MRSA with enhanced survivability against HDPs. Such adaptations appear to correlate with MRSA variations in cell membrane order and cell wall structure. DAPrstrains with or without mutations in themprFlocus demonstrated significant cross-resistance profiles to these unrelated CAPs.