Skip to main content

Advertisement

SpringerLink
Log in

Mucoid Staphylococcus haemolyticus: an unheeded multidrug-resistant pathogen

  • Clinical Microbiology - Research Paper
  • Published:
Brazilian Journal of Microbiology Aims and scope Submit manuscript

Abstract

Coagulase-negative Staphylococci (CoNS) are among the most abundant members of human skin microbiome. CoNS have lately been recognized as substantial agents in plethora of infections, especially nosocomial infections in preterm infants and immunocompromised patients. Staphylococcus haemolyticus is the second most common species isolated from blood, and identification is further hindered when there is a deviation in morphology from the classical one. Here, we report an uncommon case of multidrug resistant mucoid S. hemolyticus isolated from blood in a patient of polytrauma. The patient was managed with ceftriaxone-sulbactam, gentamicin, and meropenem as empirical therapy, which was subsequently changed to intravenous vancomycin. The patient showed favorable response to treatment. Mucoid isolates are known to be more virulent and multi-drug resistant than the classical morphotypes. We also conducted systematic review to decipher the prevalence of mucoid S. hemolyticus and linezolid (LZD) resistance in the same. This case highlights the significance of awareness of mucoid phenotypes of Gram-positive cocci for clinical microbiologists to reach accurate identification. Resistance to LZD further underscores the need of restriction policies in hospitals and to roll out antimicrobial stewardship program stringently, so that the growing resistance could be contained.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Becker K, Heilmann C, Peters G (2014) Coagulase-negative staphylococci. Clin Microbiol Rev 27:870–926

    Article  PubMed  PubMed Central  Google Scholar 

  2. Asaad AM, Ansar Qureshi M, Mujeeb HS (2016) Clinical significance of coagulase-negative staphylococci isolates from nosocomial bloodstream infections. Infect Dis Lond Engl 48:356–360

    Article  Google Scholar 

  3. Czekaj T, Ciszewski M, Szewczyk EM (2015) Staphylococcus haemolyticus – an emerging threat in the twilight of the antibiotics age. Microbiology 161:2061–2068

    Article  CAS  PubMed  Google Scholar 

  4. Schleifer K, Kloos W (1975) Isolation and characterization of Staphylococci from human skin I. Amended descriptions of Staphylococcus epidermidis and Staphylococcus saprophyticus and descriptions of three new species: Staphylococcus cohnii, Staphylococcus haemolyticus, and Staphylococcus xylosus. Int J Syst Bacteriol 25:50–61

  5. Ruzauskas M, Siugzdiniene R, Klimiene I et al (2014) Prevalence of methicillin-resistant Staphylococcus haemolyticus in companion animals: a cross-sectional study. Ann Clin Microbiol Antimicrob 13:56

    Article  PubMed  PubMed Central  Google Scholar 

  6. Chan KG, Ng KT, Chong TM et al (2015) Antibiotic resistant and virulence determinants of Staphylococcus haemolyticus C10A as revealed by whole genome sequencing. J Genomics 3:72–74

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cavanagh JP, Hjerde E, Holden MTG et al (2014) Whole-genome sequencing reveals clonal expansion of multiresistant Staphylococcus haemolyticus in European hospitals. J Antimicrob Chemother 69:2920–2927

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Fluit AC, Carpaij N, Majoor EAM et al (2013) Shared reservoir of ccrB gene sequences between coagulase-negative staphylococci and methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 68:1707–1713

    Article  CAS  PubMed  Google Scholar 

  9. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 2021.

  10. Matlani M, Shende T, Bhandari V et al (2016) Linezolid-resistant mucoid Staphylococcus haemolyticus from a tertiary-care centre in Delhi. New Microbes New Infect 11:57–58

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Nielsen SM, Norskov-Lauritsen N, Bjarnsholt T, Meyer RL (2016) Achromobacter Species isolated from cystic fibrosis patients reveal distinctly different biofilm morphotypes. Microorganisms 4:33

    Article  PubMed  PubMed Central  Google Scholar 

  12. Pritt B, O’Brien L, Winn W (2007) Mucoid Pseudomonas in cystic fibrosis. Am J Clin Pathol 128:32–34

    Article  PubMed  Google Scholar 

  13. Silva IN, Ferreira AS, Becker JD et al (2011) Mucoid morphotype variation of Burkholderia multivorans during chronic cystic fibrosis lung infection is correlated with changes in metabolism, motility, biofilm formation and virulence. Microbiol Read Engl 157:3124–3137

    Article  CAS  Google Scholar 

  14. Lennartz FE, Schwartbeck B, Dubbers A et al (2019) The prevalence of Staphylococcus aureus with mucoid phenotype in the airways of patients with cystic fibrosis-a prospective study. Int J Med Microbiol IJMM 309:283–287

    Article  CAS  PubMed  Google Scholar 

  15. Stirling J, Maeda Y, Millar BC et al (2008) Mucoid Staphylococcus aureus isolated from a patient with a suspected urinary tract infection. J Med Microbiol 57:1436–1437

    Article  PubMed  Google Scholar 

  16. Kumari S, Rawre J, Trikha A et al (2019) Linezolid-resistant Staphylococcus haemolyticus: Emergence of G2447U & C2534U mutations at the domain V of 23S ribosomal RNA gene in a tertiary care hospital in India. Indian J Med Res 149:795–798

    Article  PubMed  PubMed Central  Google Scholar 

  17. Shore AC, Lazaris A, Kinnevey PM et al (2016) First report of cfr-carrying plasmids in the pandemic sequence type 22 methicillin-resistant Staphylococcus aureus Staphylococcal cassette chromosome mec type IV clone. Antimicrob Agents Chemother 60:3007–3015

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Long KS, Poehlsgaard J, Kehrenberg C et al (2006) The Cfr rRNA methyltransferase confers resistance to phenicols, lincosamides, oxazolidinones, pleuromutilins, and streptogramin A antibiotics. Antimicrob Agents Chemother 50:2500

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Manoharan M, Sistla S, Ray P (2021) Prevalence and molecular determinants of antimicrobial resistance in clinical isolates of Staphylococcus haemolyticus from India. Microb Drug Resist 27:501–508

    Article  CAS  PubMed  Google Scholar 

  20. Gupta V, Garg S, Jain R et al (2012) Linezolid resistant Staphylococcus haemolyticus: first case report from India. Asian Pac J Trop Med 5:837–838

    Article  PubMed  Google Scholar 

  21. Anderegg TR, Sader HS, Fritsche TR et al (2005) Trends in linezolid susceptibility patterns: report from the 2002–2003 worldwide zyvox annual appraisal of potency and spectrum (ZAAPS) program. Int J Antimicrob Agents 26:13–21

    Article  CAS  PubMed  Google Scholar 

  22. Rajan V, Kumar VGS, Gopal S (2014) A cfr-positive clinical staphylococcal isolate from India with multiple mechanisms of linezolid-resistance. Indian J Med Res 139:463–467

    PubMed  PubMed Central  Google Scholar 

  23. Brijwal M, Dhawan B, Rawre J et al (2016) Clonal dissemination of linezolid-resistant Staphylococcus haemolyticus harbouring a G2576T mutation and the cfr gene in an Indian hospital. J Med Microbiol 65:698–700

    Article  PubMed  Google Scholar 

  24. Rajan V, Prakash PH, Gopal S (2017) Occurrence of linezolid-resistant Staphylococcus haemolyticus in two tertiary care hospitals in Mysuru. South India J Glob Antimicrob Resist 8:140–141

    Article  PubMed  Google Scholar 

  25. Rajkumar S, Sistla S, Manoharan M et al (2017) Prevalence and genetic mechanisms of antimicrobial resistance in Staphylococcus species: a multicentre report of the indian council of medical research antimicrobial resistance surveillance network. Indian J Med Microbiol 35:53–60

    Article  PubMed  Google Scholar 

  26. Vijayan P, Srinivas D, Siddaiah N et al (2019) Device-associated meningitis by linezolid-resistant Staphylococcus haemolyticus in a vancomycin- hypersensitive patient. J Neurosci Rural Pract 10:718–720

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bakthavatchalam YD, Vasudevan K et al (2020) First draft genome sequence of linezolid and rifampicin resistant Staphylococcus haemolyticus. Jpn J Infect Dis 73:296–299

    Article  CAS  PubMed  Google Scholar 

  28. Gupta V, Gulati N, Sharma S et al (2020) Linezolid resistance in Staphylococcus haemolyticus - case series and review of literature. Infect Disord Drug Targets 20:713–717

    Article  CAS  PubMed  Google Scholar 

  29. Chaturvedi P, Pandey A (2020) Linezolid resistant clinically significant isolates of coagulase negative staphylococci: an emerging therapeutic concern. Indian J Public Health Res Dev 11:263–268

    Google Scholar 

  30. Sajitha V, Das P, Wankhade A, Segi SS, Bhargava A (2021) A retrospective analysis of clinical isolates of coagulase negative staphylococci species from different patient samples. Indian J Med Microbiol 39:18

    Article  Google Scholar 

  31. Tk D, Samuel S, Rudrapathy P, Murugesan S, Ke S (2022) Antibiotic resistance, mecA gene detection, and biofilm formation ability among coagulase-negative staphylococci in cancer patients. Asian J Pharm Clin Res 35–9

Download references

Author information

Authors and Affiliations

  1. Department of Microbiology, GMCH-32, Chandigarh, India

    Lipika Singhal, Varsha Gupta, Swati Sharma, Aditi Agarwal & Parakriti Gupta

Authors
  1. Lipika Singhal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Varsha Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Swati Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aditi Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Parakriti Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Study was conceptualized by LG, VG, and PG. Material preparation, data collection, and analysis were performed by SS, AA, and PG. The first draft of the manuscript was written by PG and SS and approved by PG, LG, and VG. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Parakriti Gupta.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Responsible Editor: Fernando R. Pavan

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Singhal, L., Gupta, V., Sharma, S. et al. Mucoid Staphylococcus haemolyticus: an unheeded multidrug-resistant pathogen. Braz J Microbiol 54, 191–198 (2023). https://doi.org/10.1007/s42770-022-00901-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42770-022-00901-3

Keywords

Search

Navigation