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Possible misinterpretation of penicillin susceptibility in Staphylococcus aureus blood isolate due to in vitro loss of the blaZ gene

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Abstract

We describe a case of recurrent catheter-related blood stream infections (BSI) with Staphylococcus aureus, in which the first isolate tested susceptible to penicillin, while subsequent isolates were resistant. Phenotypic susceptibility correlated with the absence/presence of the blaZ gene. The in vitro stability of penicillin resistance was investigated by subculturing single colonies. In two out of five colonies, phenotypical resistance was lost after a single subculture, which correlated with loss of the blaZ gene. This in vitro phenomenon probably resulted in a very major error in the microbiology report of the first BSI, where penicillin had been recommended as treatment.

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Acknowledgements

We thank Karen Astvad, Lone Ryste Hansen Kildevang, Alexandra Medina, and Hülya Kaya, Statens Serum Institut, for technical assistance, and Robert L. Skov, Statens Serum Institut, for critical discussion during the study performance.

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Authors

Contributions

Conception of the work: HBE, AP, ARL, BJH

Laboratory investigation and bioinformatics: HBE, AP, MP, SOP, BJH

Drafting of the article: HBE, AP, MP, ARL, BJH

Critical revision of the article: HBE, AP, MP, SOP, ARL, BJH

Final approval of the version to be published: HBE, AP, MP, SOP, ARL, BJH

Corresponding author

Correspondence to Helle Brander Eriksen.

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This in vitro study was not subject to approval requirements from the Danish Committee System on Health Research Ethics.

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The authors declare no competing interests.

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Eriksen, H.B., Petersen, A., Pedersen, M. et al. Possible misinterpretation of penicillin susceptibility in Staphylococcus aureus blood isolate due to in vitro loss of the blaZ gene. Eur J Clin Microbiol Infect Dis 41, 163–167 (2022). https://doi.org/10.1007/s10096-021-04344-w

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  • DOI: https://doi.org/10.1007/s10096-021-04344-w

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