{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T12:37:28Z","timestamp":1791117448295,"version":"4.1.0"},"reference-count":51,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2006,9,1]],"date-time":"2006-09-01T00:00:00Z","timestamp":1157068800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Low-level vancomycin-resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (vancomycin-intermediate\n                    <jats:italic>S. aureus<\/jats:italic>\n                    [VISA] and heterogenous VISA [hVISA]) is increasingly reported and leads to glycopeptide treatment failure. Various phenotypic features have been reported for these isolates, but the genetic changes leading to hVISA and VISA have yet to be clearly determined. We assessed phenotypic, antibiotic resistance, and genomic changes by using genomic DNA microarray comparison and sequencing of selected loci in five pairs of clinical hVISA\/VISA strains and the initial methicillin-resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (MRSA) isolates obtained prior to vancomycin therapy. The isolates were from adult patients in Australia and New Zealand who had persistent MRSA bacteremia (&gt;7 days) while receiving vancomycin therapy. In all cases, the initial isolates were found to be fully vancomycin-susceptible\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (VSSA). The hVISA\/VISA phenotype was associated with increased cell wall thickness, reduced autolytic activity in four of five hVISA\/VISA strains, and a striking reduction in biofilm formation compared to the parent strains in all pairs. All five pairs appeared to be isogenic, and genomic DNA microarray comparison suggested that major genetic changes are not required for the development of the resistant phenotype in these strains. No sequence differences were found in the\n                    <jats:italic>agr<\/jats:italic>\n                    locus or the\n                    <jats:italic>tcaRA<\/jats:italic>\n                    genes for any pair, but a marked reduction in RNAIII expression was found in four pairs. In summary, hVISA\/VISA arises from fully VSSA during persistent infection that fails to respond to glycopeptide therapy and is associated with significant phenotypic changes, including a marked reduction in biofilm-forming ability. These clinically derived pairs of isolates will be a useful resource to elucidate the genetic mechanism of resistance in hVISA\/VISA strains.\n                  <\/jats:p>","DOI":"10.1128\/aac.00422-06","type":"journal-article","created":{"date-parts":[[2006,8,28]],"date-time":"2006-08-28T14:10:56Z","timestamp":1156774256000},"page":"3039-3047","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":193,"title":["Isolates with Low-Level Vancomycin Resistance Associated with Persistent Methicillin-Resistant\n                    <i>Staphylococcus aureus<\/i>\n                    Bacteremia"],"prefix":"10.1128","volume":"50","author":[{"given":"Benjamin P.","family":"Howden","sequence":"first","affiliation":[{"name":"Australian Bacterial Pathogenesis Program, Department of Microbiology, Monash University, Wellington Rd., Clayton, Victoria, Australia"},{"name":"Departments of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D. R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Departments of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter B.","family":"Ward","sequence":"additional","affiliation":[{"name":"Microbiology, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy P.","family":"Stinear","sequence":"additional","affiliation":[{"name":"Australian Bacterial Pathogenesis Program, Department of Microbiology, Monash University, Wellington Rd., Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Davies","sequence":"additional","affiliation":[{"name":"Australian Bacterial Pathogenesis Program, Department of Microbiology, Monash University, Wellington Rd., Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.36.8.2187-2190.1998"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.3.3.418"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.6.2036-2039.2003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-4165(00)00133-1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/381093"},{"key":"e_1_3_2_7_2","unstructured":"Clinical and Laboratory Standards Institute. 2006. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically 7th ed. Approved standard. CLSI document M7-A7. Clinical and Laboratory Standards Institute Wayne Pa."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/JB.183.9.2888-2896.2001"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.2.428-438.2006"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.8.3404-3413.2005"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.1.5-14.2003"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.15.2.167-193.2002"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0029(19970301)36:5<422::AID-JEMT12>3.0.CO;2-U"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-842X(98)01400-0"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1086\/346207"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/42.2.199"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.12.5442-5448.2003"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.64.1.277-282.1996"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2958.1996.tb02548.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(01)00091-3"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001432-200208000-00009"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-004-1261-y"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1086\/381202"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1005.030556"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.2.792-799.2004"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1006\/bbrc.2000.2277"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.10.3040-3045.2003"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.6.1953-1959.2004"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/JB.185.15.4638-4643.2003"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.4.1262-1266.2003"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.4.1574-1585.2003"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2958.2003.03526.x"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.8.2492-2498.2003"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.2.294-303.2000"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)79166-2"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.8.2958-2965.2004"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/gb-2002-3-7-research0034"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.5.1492-1502.2002"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1086\/368128"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.7.2687-2692.2005"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.179.8.2557-2566.1997"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1128\/JB.185.24.7103-7110.2003"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902183400704"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.4.1687-1693.2003"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.qco.0000171923.62699.0c"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.4.1541-1545.2006"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.3.1024-1027.2004"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1086\/317606"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.micro.56.012302.160806"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/47.4.399"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbagen.2005.09.002"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1128\/JB.187.16.5585-5594.2005"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00422-06","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00422-06","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T14:15:27Z","timestamp":1645452927000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.00422-06"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,9]]},"references-count":51,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2006,9]]}},"alternative-id":["10.1128\/AAC.00422-06"],"URL":"https:\/\/doi.org\/10.1128\/aac.00422-06","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,9]]},"assertion":[{"value":"2006-04-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2006-07-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2006-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}