{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:03:07Z","timestamp":1789567387738,"version":"build-2803163510"},"reference-count":45,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"MOST | National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81971977"],"award-info":[{"award-number":["81971977"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"MOST | National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82172308"],"award-info":[{"award-number":["82172308"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"\u6d59\u6c5f\u7701\u536b\u751f\u59d4\u5458\u4f1a | Medical and Health Research Project of Zhejiang Province","award":["2019KY427"],"award-info":[{"award-number":["2019KY427"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2023,11,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Daptomycin (DAP) is effective against methicillin-resistant\n            <jats:italic>Staphylococcus aureus<\/jats:italic>\n            (MRSA). However, reduced susceptibility to DAP in MRSA may lead to treatment failures. We aim to determine the distribution of DAP minimum inhibitory concentrations (MICs) and DAP heteroresistance (hDAP) among MRSA lineages in China. A total of 472 clinical MRSA isolates collected from 2015 to 2017 in China were examined for DAP susceptibility. All isolates (\n            <jats:italic>n<\/jats:italic>\n            = 472) were found to be DAP susceptible, but 35.17% (166\/472) of them exhibited a high DAP MIC (MIC &gt;0.5 \u00b5g\/mL). The high DAP MIC group contained a larger proportion of isolates with a higher vancomycin or teicoplanin MIC (&gt;1.5 \u00b5g\/mL) than the low DAP MIC group (19.3% vs 7.8%,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001; 22.3% vs 8.2%,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). We compared the clonal complex (CC) distributions and clinical characteristics in MRSA isolates stratified by DAP MIC. CC5 isolates were less susceptible to DAP (MIC\n            <jats:sub>50<\/jats:sub>\n            = 1 \u00b5g\/mL) than CC59 isolates (MIC\n            <jats:sub>50<\/jats:sub>\n            = 0.5 \u00b5g\/mL,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). Population analysis profiling revealed that 5 of 10 ST5 and ST59 DAP-susceptible MRSA isolates investigated exhibited hDAP. The results also showed that CC5 MRSA with an\n            <jats:italic>agrA<\/jats:italic>\n            mutation (I238K) had a higher DAP MIC than those with a wild-type\n            <jats:italic>agrA<\/jats:italic>\n            (\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). The\n            <jats:italic>agrA<\/jats:italic>\n            -I238K mutation was found to be associated with\n            <jats:italic>agr<\/jats:italic>\n            dysfunction as indicated by the loss of \u03b4-hemolysin production. In addition,\n            <jats:italic>agr\/psm\u03b1<\/jats:italic>\n            defectiveness was associated with hDAP in MRSA. Whole-genome sequencing analysis revealed mutations in\n            <jats:italic>mprF<\/jats:italic>\n            and\n            <jats:italic>walR<\/jats:italic>\n            \/\n            <jats:italic>walK<\/jats:italic>\n            in DAP-resistant subpopulations, and most DAP-resistant subpopulations (6\/8, 75%) were stable. Our study suggests that the increased DAP resistance and hDAP in MRSA may threaten the effectiveness against MRSA infections.\n          <\/jats:p>","DOI":"10.1128\/aac.00563-23","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:05:00Z","timestamp":1698671100000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":9,"title":["Profiling daptomycin resistance among diverse methicillin-resistant\n            <i>Staphylococcus aureus<\/i>\n            lineages in China"],"prefix":"10.1128","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9973-3404","authenticated-orcid":false,"given":"Shengnan","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengzhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxiong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"},{"name":"Xihu District Center for Disease Control and Prevention of Hangzhou , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3882-3585","authenticated-orcid":true,"given":"Xiaoliang","family":"Ba","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine, University of Cambridge , Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueqin","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemu","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feiteng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province , Hangzhou, China"},{"name":"Regional Medical Center for National Institute of Respiratory 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