Background: Coagulase-negative staphylococci (CoNS) are a major cause of nosocomial blood stream infection, especially in critically ill and haematology patients. CoNS are usually multidrug-resistant and glycopeptide antibiotics have been to date considered the drugs of choice for treatment. The aim of this study was to characterize CoNS with reduced susceptibility to glycopeptides causing blood stream infection (BSI) in critically ill and haematology patients at the University Hospital Tor Vergata, Rome, Italy, in 2007. Methods: Hospital microbiology records for transplant haematology and ICU were reviewed to identify CoNS with elevated MICs for glycopeptides, and isolates were matched to clinical records to determine whether the isolates caused a BSI. The isolates were tested for susceptibility to new drugs daptomicin and tigecycline and the genetic relationship was assessed using f-AFLP. Results: Of a total of 17,418 blood cultures, 1,609 were positive for CoNS and of these, 87 (5.4%) displayed reduced susceptibility to glycopeptides. Clinical review revealed that in 13 cases (7 in haematology and 6 in ICU), CoNS with reduced susceptibility to glycopeptides were responsible for a BSI. Staphylococcus epidermidis was the causative organism in 11 instances and Staphylococcus haemolyticus in 2. The incidence of oxacillin resistance was high (77%), although all isolates remained susceptible to linezolid, daptomycin and tigecycline. Fingerprinting of CoNS identified one clonal relationship between two isolates. Conclusion: Multi-resistant CoNS with reduced susceptibility to glycopeptides, although still relatively infrequent in our hospital, are emerging pathogens of clinical concern. Surveillance by antibiotyping with attention to multi-resistant profile, and warning to clinicians, is necessary.

Natoli, S., Fontana, C., Favaro, M., Bergamini, A., Testore, G.p., Minelli, S., et al. (2009). Characterization of coagulase-negative staphylococcal isolates from blood with reduced susceptibility to glycopeptides and therapeutic options. BMC INFECTIOUS DISEASES, 9 [10.1186/1471-2334-9-83].

Characterization of coagulase-negative staphylococcal isolates from blood with reduced susceptibility to glycopeptides and therapeutic options

NATOLI, SILVIA;FONTANA, CARLA;FAVARO, MARCO;BERGAMINI, ALBERTO;TESTORE, GIAN PIERO;CUDILLO, LAURA;LEONARDIS, FRANCESCA
2009-01-01

Abstract

Background: Coagulase-negative staphylococci (CoNS) are a major cause of nosocomial blood stream infection, especially in critically ill and haematology patients. CoNS are usually multidrug-resistant and glycopeptide antibiotics have been to date considered the drugs of choice for treatment. The aim of this study was to characterize CoNS with reduced susceptibility to glycopeptides causing blood stream infection (BSI) in critically ill and haematology patients at the University Hospital Tor Vergata, Rome, Italy, in 2007. Methods: Hospital microbiology records for transplant haematology and ICU were reviewed to identify CoNS with elevated MICs for glycopeptides, and isolates were matched to clinical records to determine whether the isolates caused a BSI. The isolates were tested for susceptibility to new drugs daptomicin and tigecycline and the genetic relationship was assessed using f-AFLP. Results: Of a total of 17,418 blood cultures, 1,609 were positive for CoNS and of these, 87 (5.4%) displayed reduced susceptibility to glycopeptides. Clinical review revealed that in 13 cases (7 in haematology and 6 in ICU), CoNS with reduced susceptibility to glycopeptides were responsible for a BSI. Staphylococcus epidermidis was the causative organism in 11 instances and Staphylococcus haemolyticus in 2. The incidence of oxacillin resistance was high (77%), although all isolates remained susceptible to linezolid, daptomycin and tigecycline. Fingerprinting of CoNS identified one clonal relationship between two isolates. Conclusion: Multi-resistant CoNS with reduced susceptibility to glycopeptides, although still relatively infrequent in our hospital, are emerging pathogens of clinical concern. Surveillance by antibiotyping with attention to multi-resistant profile, and warning to clinicians, is necessary.
2009
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/41 - ANESTESIOLOGIA
English
Con Impact Factor ISI
daptomycin; linezolid; macrolide; oxacillin; polypeptide antibiotic agent; teicoplanin; tigecycline; vancomycin; antiinfective agent; glycopeptide; adult; aged; antibiotic sensitivity; article; bacterium isolate; blood culture; bloodstream infection; coagulase negative Staphylococcus; controlled study; critically ill patient; DNA fingerprinting; genetic correlation; hospital infection; human; Italy; major clinical study; microbiological examination; minimum inhibitory concentration; nonhuman; Staphylococcus epidermidis; Staphylococcus haemolyticus; amplified fragment length polymorphism; bacterium identification; blood; classification; drug effect; genetics; middle aged; multidrug resistance; Staphylococcus infection; Adult; Aged; Aged, 80 and over; Amplified Fragment Length Polymorphism Analysis; Anti-Bacterial Agents; Bacterial Typing Techniques; Drug Resistance, Multiple, Bacterial; Glycopeptides; Humans; Middle Aged; Staphylococcal Infections; Staphylococcus epidermidis; Staphylococcus haemolyticus
Natoli, S., Fontana, C., Favaro, M., Bergamini, A., Testore, G.p., Minelli, S., et al. (2009). Characterization of coagulase-negative staphylococcal isolates from blood with reduced susceptibility to glycopeptides and therapeutic options. BMC INFECTIOUS DISEASES, 9 [10.1186/1471-2334-9-83].
Natoli, S; Fontana, C; Favaro, M; Bergamini, A; Testore, Gp; Minelli, S; Bossa, M; Casapulla, M; Broglio, G; Beltrame, A; Cudillo, L; Cerretti, R; Leonardis, F
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/48145
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