Aim: To determine the presence of vancomycin heteroresistance in Staphylococcus haemolyticus. Materials & methods: A total of 48 rifampicin-resistant S. haemolyticus isolates from bloodstream infections were included. Vancomycin heteroresistance was determined using the population analysis profile-area under curve (PAP-AUC) method. All the isolates were screened for the presence of mecA gene, mutations in the rpoB gene, staphylococcal cassette chromosome mec and multilocus sequence types. Results: Fifteen isolates were identified as heteroresistant vancomycin-intermediate S. haemolyticus using PAP-AUC method. Dual rpoB mutations (D471E and I527M) contributed for the rifampicin resistance. The sequence types of heteroresistant vancomycin-intermediate S. haemolyticus were highly diverse. Conclusion: These findings illustrate the potential of S. haemolyticus to develop heteroresistance, which emphasizes the need for routine surveillance of S. haemolyticus isolated from intensive care units for infection control practices.

Lay abstract

The problem of vancomycin-resistant subpopulations of coagulase-negative Staphylococci is rising worldwide; and may adversely affect the response to treatment. This study was conducted to characterize the resistant subpopulations of Staphylococcus haemolyticus that cause bloodstream infection, which is largely unexplored. We observed the presence of vancomycin-resistant subpopulations of S. haemoltyicus, which are not tested routinely yet should be monitored regularly to potentially improve clinical outcomes.

Keywords:

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Vol. 7, No. 7

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History

Received 16 October 2020

Accepted 4 March 2021

Published online 9 April 2021

Published in print August 2021

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Keywords

Author contributions

YD Bathavatchalam contributed to study conduction, data collection, analysis and manuscript writing. D Solaimalai and A Amladi contributed to data, population and profile-area under curve analysis. HT Dwarakanathan, S Anandan and B Veeraraghavan contributed participated in critical review of the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The study was approved by the Institutional Review Board (IRB No: 11810).

Open access

This work is licensed under the Creative Commons Attribution 4.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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