Tigecycline induction of phenol-soluble modulins by invasive methicillin-resistant Staphylococcus aureus strains.

We examined the effects of tigecycline on three types of exoproteins, α-type phenol-soluble modulins (PSMα1 to PSMα4), α-hemolysin, and protein A, in 13 methicillin-resistant Staphylococcus aureus isolates compared to those of clindamycin and linezolid. Paradoxical increases in PSMαs occurred in 77% of the isolates with tigecycline at 1/4 and 1/8 MICs and clindamycin at 1/8 MIC compared to only 23% of the isolates with linezolid at 1/8 MIC. Induction was specific to PSMα1 to PSMα4, as protein A and α-hemolysin production was decreased under the same conditions by all of the antibiotics used.