Daptomycin (DAP) has potent activity in vitro and in vivo
against both methicillin-susceptible Staphylococcus aureus
(MSSA) and methicillin-resistant S. aureus (MRSA) strains.
DAP-resistance (DAP-R) in S. aureus has been mainly observed
in MRSA strains, and has been linked to single nucleotide
polymorphisms (SNPs) within the mprF gene leading
to altered cell membrane (CM) phospholipid (PL) profiles,
enhanced positive surface charge, and changes in CM
fluidity. The current study was designed to delineate whether
these same genotypic and phenotypic perturbations are demonstrated
in clinically-derived DAP-R MSSA strains. We
used three isogenic DAP-susceptible (DAP-S)/DAP-R strainpairs
and compared: (i) presence of mprF SNPs, (ii) temporal
expression profiles of the two key determinants (mprF and
dltABCD) of net positive surface charge, (iii) increased production
of mprF-dependent lysinylated-phosphatidylglycerol
(L-PG), (iv) positive surface charge assays, and (v) susceptibility
to cationic host defense peptides (HDPs) of neutrophil
and platelet origins. Similar to prior data in MRSA, DAP-R
(vs DAP-S) MSSA strains exhibited hallmark hot-spot SNPs
in mprF, enhanced and dysregulated expression of both mprF
and dltA, L-PG overproduction, HDP resistance and enhanced
positive surface charge profiles. However, in contrast to most
DAP-R MRSA strains, there were no changes in CM fluidity
seen. Thus, charge repulsion via mprF- and dlt-mediated enhancement
of positive surface charge may be the main mechanism
to explain DAP-R in MSSA strains.
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