The cfr gene was identified in 3 methicillin-resistant Staphylococcus epidermidis (MRSE) isolates of lineage ST22 implicated in a fatal human infection. MRSE isolates displayed an indistinguishable pulsed-field gel electrophoresis profile and SCCmec type III, and showed a multiresistance phenotype. The presence of cfr, fexA, aac(6')-aph(2″), and dfrS1 genes was confirmed by polymerase chain reaction and sequencing. A mutation in 23S rRNA gene (C2534T) and amino acid changes and/or insertions in L3 and L4 proteins were detected. The cfr and fexA genes were located in a conjugative plasmid of approximately 45 kb and in the chromosome.
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