UNIGE document Scientific Article
previous document  unige:28379  next document
add to browser collection
Title

Prevalence of isolates with reduced glycopeptide susceptibility in orthopedic device-related infections due to methicillin-resistant Staphylococcus aureus

Authors
Ferry, T
Published in European Journal of Clinical Microbiology & Infectious Diseases. 2012, vol. 31, no. 12, p. 3367-74
Abstract We evaluated, by an improved susceptibility testing method, the prevalence and significance of low-level glycopeptide resistance in methicillin-resistant Staphylococcus aureus (MRSA) isolates, which belonged to a previously described, retrospective cohort of patients treated for orthopedic device-related infections (ODRI) at the Geneva University Hospital between 2000 and 2008. Fifty-seven individual or multiple isolates were retrieved from 41 ODRI patients for glycopeptide susceptibility and clonality studies, including 20 patients with prosthetic joint (PJ) and 21 with osteosynthesis (OS) MRSA infections. Low-level glycopeptide resistance was detected by elevated teicoplanin or/and vancomycin minimum inhibitory concentrations (MICs ≥ 4 mg/L), as determined by a previously validated combination of macrodilution and agar dilution assays of improved sensitivity. MRSA isolates with elevated teicoplanin MICs were detected in 20/41 (49 %) ODRI patients at the onset or during the course of glycopeptide therapy, namely, in 10 of 20 patients with PJ and 10 of 21 patients with OS infections. Only one isolate developed a concomitant increase in vancomycin MIC during therapy. 13/20 (65 %) glycopeptide-intermediate S. aureus (GISA)-infected patients, including 7/10 (70 %) with PJ and 6/10 (60 %) with OS, experienced treatment failure. In contrast, therapy failed in only 5/21 (24 %) ODRI patients with non-GISA isolates (p = 0.012), including 2/10 (20 %) with PJ and 3/11 (27 %) with OS infections. The emergence of low-level teicoplanin resistance could not be explained by teicoplanin administration, since only four patients received teicoplanin. The evaluation of low-level teicoplanin resistance may improve the detection of GISA isolates. Further studies are warranted to evaluate the impact of low-level teicoplanin resistance on the outcome of glycopeptide therapy.
Keywords AdultAgedAged, 80 and overAnti-Bacterial Agents/pharmacology/therapeutic useDrug Resistance, BacterialFemaleGlycopeptides/pharmacology/therapeutic useHumansMaleMethicillin-Resistant Staphylococcus aureus/drug effects/isolation & purificationMicrobial Sensitivity TestsMiddle AgedProsthesis-Related Infections/microbiologyStaphylococcal Infections/microbiologyTeicoplanin/pharmacology/therapeutic useTreatment OutcomeVancomycin/pharmacology/therapeutic useYoung Adult
Identifiers
PMID: 22833247
Full text
Article (Published version) (173 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research groups Analyse génomique et fonctionnelle du staphylocoque doré (604)
Groupe Harbarth Stephan (Staphylocoques dorés résistants à la méthicilline) (866)
Groupe Laurent Kaiser (virologie clinique) (668)
Citation
(ISO format)
VAUDAUX, Pierre et al. Prevalence of isolates with reduced glycopeptide susceptibility in orthopedic device-related infections due to methicillin-resistant Staphylococcus aureus. In: European Journal of Clinical Microbiology & Infectious Diseases, 2012, vol. 31, n° 12, p. 3367-74. https://archive-ouverte.unige.ch/unige:28379

192 hits

0 download

Update

Deposited on : 2013-06-04

Export document
Format :
Citation style :