Emergence of methicillin-resistant clones from cephamycin-resistant Staphylococcus aureus.

Staphylococcus aureus strains specifically resistant to cephamycin antibiotics have been found among recent clinical isolates. These strains formed penicillin-binding protein (PBP) 2' and became phenotypically resistant to methicillin after induction with cefoxitin. Other cephamycin-type antibiotics also induced methicillin-resistance, whereas non-cephamycin-type cephalosporins such as cefmenoxime and ceftizoxime did not do so. The clones that constitutively synthesized PBP 2' arose from the cephamycin-resistant strains at a frequency of 10(-5). They were indistinguishable from clinically isolated methicillin-resistant S. aureus (MRSA). Cephamycin-resistant S. aureus may be a source for emerging MRSA.