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Tebano G, Zaghi I, Baldasso F, Calgarini C, Capozzi R, Salvadori C, Cricca M, Cristini F. Antibiotic Resistance to Molecules Commonly Prescribed for the Treatment of Antibiotic-Resistant Gram-Positive Pathogens: What Is Relevant for the Clinician? Pathogens 2024; 13:88. [PMID: 38276161 PMCID: PMC10819222 DOI: 10.3390/pathogens13010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
Antibiotic resistance in Gram-positive pathogens is a relevant concern, particularly in the hospital setting. Several antibiotics are now available to treat these drug-resistant pathogens, such as daptomycin, dalbavancin, linezolid, tedizolid, ceftaroline, ceftobiprole, and fosfomycin. However, antibiotic resistance can also affect these newer molecules. Overall, this is not a frequent phenomenon, but it is a growing concern in some settings and can compromise the effectiveness of these molecules, leaving few therapeutic options. We reviewed the available evidence about the epidemiology of antibiotic resistance to these antibiotics and the main molecular mechanisms of resistance, particularly methicillin-resistant Sthaphylococcus aureus, methicillin-resistant coagulase-negative staphylococci, vancomycin-resistant Enterococcus faecium, and penicillin-resistant Streptococcus pneumoniae. We discussed the interpretation of susceptibility tests when minimum inhibitory concentrations are not available. We focused on the risk of the emergence of resistance during treatment, particularly for daptomycin and fosfomycin, and we discussed the strategies that can be implemented to reduce this phenomenon, which can lead to clinical failure despite appropriate antibiotic treatment. The judicious use of antibiotics, epidemiological surveillance, and infection control measures is essential to preserving the efficacy of these drugs.
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Affiliation(s)
- Gianpiero Tebano
- Infectious Diseases Unit, AUSL Romagna, Ravenna Hospital, 48121 Ravenna, Italy; (I.Z.); (C.C.); (C.S.)
| | - Irene Zaghi
- Infectious Diseases Unit, AUSL Romagna, Ravenna Hospital, 48121 Ravenna, Italy; (I.Z.); (C.C.); (C.S.)
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522 Cesena, Italy;
| | - Francesco Baldasso
- Infectious Diseases Unit, AUSL Romagna, Forlì and Cesena Hospitals, 47121 Forlì and Cesena, Italy; (F.B.); (R.C.); (F.C.)
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Chiara Calgarini
- Infectious Diseases Unit, AUSL Romagna, Ravenna Hospital, 48121 Ravenna, Italy; (I.Z.); (C.C.); (C.S.)
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Roberta Capozzi
- Infectious Diseases Unit, AUSL Romagna, Forlì and Cesena Hospitals, 47121 Forlì and Cesena, Italy; (F.B.); (R.C.); (F.C.)
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Caterina Salvadori
- Infectious Diseases Unit, AUSL Romagna, Ravenna Hospital, 48121 Ravenna, Italy; (I.Z.); (C.C.); (C.S.)
| | - Monica Cricca
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522 Cesena, Italy;
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Francesco Cristini
- Infectious Diseases Unit, AUSL Romagna, Forlì and Cesena Hospitals, 47121 Forlì and Cesena, Italy; (F.B.); (R.C.); (F.C.)
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When Good Bugs Go Bad: Epidemiology and Antimicrobial Resistance Profiles of Corynebacterium striatum, an Emerging Multidrug-Resistant, Opportunistic Pathogen. Antimicrob Agents Chemother 2017; 61:AAC.01111-17. [PMID: 28848008 DOI: 10.1128/aac.01111-17] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/09/2017] [Indexed: 01/11/2023] Open
Abstract
Infections with Corynebacterium striatum have been described in the literature over the last 2 decades, with the majority being bacteremia, central line infections, and occasionally, endocarditis. In recent years, the frequency of C. striatum infections appears to be increasing; a factor likely contributing to this is the increased ease and accuracy of the identification of Corynebacterium spp., including C. striatum, from clinical cultures. The objective of this study was to retrospectively characterize C. striatum isolates recovered from specimens submitted as part of routine patient care at a 1,250-bed, tertiary-care academic medical center. Multiple strain types were recovered, as demonstrated by repetitive-sequence-based PCR. Most of the strains of C. striatum characterized were resistant to antimicrobials commonly used to treat Gram-positive organisms, such as penicillin, ceftriaxone, meropenem, clindamycin, and tetracycline. The MIC50 for ceftaroline was >32 μg/ml. Although there are no interpretive criteria for susceptibility with telavancin, it appeared to have potent in vitro efficacy against this species, with MIC50 and MIC90 values of 0.064 and 0.125 μg/ml, respectively. Finally, as previously reported in case studies, we demonstrated rapid in vitro development of daptomycin resistance in 100% of the isolates tested (n = 50), indicating that caution should be exhibited when using daptomycin for the treatment of C. striatum infections. C. striatum is an emerging, multidrug-resistant pathogen that can be associated with a variety of infection types.
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Rolston KVI, Jamal MA, Nesher L, Shelburne SA, Raad I, Prince RA. In vitro activity of ceftaroline and comparator agents against Gram-positive and Gram-negative clinical isolates from cancer patients. Int J Antimicrob Agents 2017; 49:416-421. [PMID: 28257904 DOI: 10.1016/j.ijantimicag.2016.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 12/02/2016] [Accepted: 12/17/2016] [Indexed: 10/20/2022]
Abstract
Bacterial infections are common in cancer patients. Ceftaroline (CFT) is a broad-spectrum cephalosporin with activity against most Gram-positive organisms (GPOs) and many Gram-negative organisms. In this study, the in vitro activity of CFT was compared with vancomycin (VAN), daptomycin (DAP), linezolid (LZD), trimethoprim/sulphamethoxazole (SXT) and tigecycline (TIG) against bacteria (predominantly blood culture isolates) isolated from cancer patients in 2014 and 2015. CFT was active against methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-susceptible coagulase-negative staphylococci (MS-CoNS) and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) with MIC90 values (minimum inhibitory concentration that inhibited 90% of the isolates) of 0.25, 2.0, 0.12 and 0.5 mg/L, respectively. MIC90 values for other GPOs were: Bacillus spp., >8.0 mg/L; Corynebacterium spp., 2.0 mg/L; Micrococcus spp., <0.06 mg/L; viridans group streptococci, 0.5 mg/L; Streptococcus pneumoniae, 0.25 mg/L; and Streptococcus spp., <0.06 mg/L. Among the comparator agents, VAN, DAP, TIG and LZD were active against the majority of GPOs tested. CFT also had moderate activity against common extended-spectrum β-lactamase (ESBL)-negative Gram-negative bacilli such as Enterobacter cloacae, Escherichia coli, Klebsiella spp., Proteus mirabilis and Serratia spp.
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Affiliation(s)
- Kenneth V I Rolston
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The University of Houston College of Pharmacy, Houston, TX, USA.
| | - Mohamed A Jamal
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lior Nesher
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Samuel A Shelburne
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Issam Raad
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Randall A Prince
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The University of Houston College of Pharmacy, Houston, TX, USA
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Xu LQ, Zeng JW, Jiang CH, Wang H, Li YZ, Wen WH, Li JH, Wang F, Ting WJ, Sun ZY, Huang CY. Isolation and determination of four potential antimicrobial components from Pseudomonas aeruginosa extracts. Int J Med Sci 2017; 14:1368-1374. [PMID: 29200950 PMCID: PMC5707753 DOI: 10.7150/ijms.18896] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 10/11/2017] [Indexed: 11/25/2022] Open
Abstract
Background:Pseudomonas aeruginosa can cause disease and also can be isolated from the skin of healthy people. Additionally, it exhibits certain antimicrobial effects against other microorganisms.Methods: We collected 60 strains of P. aeruginosa and screened their antimicrobial effects against Staphylococcus aureus (ATCC 25923) using the filter paper-disk method, the cross-streaking method and the co-culture method and then evaluated the antimicrobial activity of the chloroform-isolated S. aureus extracts against methicillin-resistant S. aureus (MRSA, Gram-positive cocci), vancomycin intermediate-resistant S. aureus (VISA, Gram-positive cocci), Corynebacterium spp. (CS, Gram-positive bacilli), Acinetobacter baumannii (AB, Gram-negative bacilli), Moraxella catarrhalis (MC, Gram-negative diplococcus), Candida albicans (CA, fungi), Candida tropicalis (CT, fungi), Candida glabrata (CG, fungi) and Candida parapsilosis (CP, fungi). Results: The PA06 and PA46 strains have strong antimicrobial effects. High-performance liquid chromatography (HPLC) analysis revealed that the major components of PA06 and PA46 that exhibit antimicrobial activity are functionally similar to phenazine-1-carboxylic acid (PCA) and pyocyanin. Preparative HPLC was performed to separate and isolate the 4 major potential antimicrobial components: PA06ER10, PA06ER16, PA06ER23 and PA06ER31. Further, the molecular masses of PA06ER10 (260.1), PA06ER16 (274.1), PA06ER23 (286.1) and PA06ER31 (318.2) were determined by electrospray ionization (ESI) mass spectrometry. Conclusion:P. aeruginosa can produce small molecules with potential antimicrobial activities against MRSA, VISA, CS, MC, CA, CT, CG and CP but not against AB.
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Affiliation(s)
- Ling-Qing Xu
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Jian-Wen Zeng
- Department of Urology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Chong-He Jiang
- Department of Urology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Huan Wang
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Yu-Zhen Li
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Wei-Hong Wen
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Jie-Hua Li
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China
| | - Feng Wang
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Wei-Jen Ting
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Guangdong, China.,Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Zi-Yong Sun
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Chih-Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.,Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan.,Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
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Mayers DL, Sobel JD, Ouellette M, Kaye KS, Marchaim D. Antibiotic Resistance of Non-pneumococcal Streptococci and Its Clinical Impact. ANTIMICROBIAL DRUG RESISTANCE 2017. [PMCID: PMC7123568 DOI: 10.1007/978-3-319-47266-9_2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The taxonomy of streptococci has undergone major changes during the last two decades. The present classification is based on both phenotypic and genotypic data. Phylogenetic classification of streptococci is based on 16S rRNA sequences [1], and it forms the backbone of the overall classification system of streptococci. Phenotypic properties are also important, especially for clinical microbiologists. The type of hemolysis on blood agar, reaction with Lancefield grouping antisera, resistance to optochin, and bile solubility remain important for grouping of clinical Streptococcus isolates and therefore treatment options [2]. In the following chapter, two phenotypic classification groups, viridans group streptococci (VGS) and beta-hemolytic streptococci, will be discussed.
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Affiliation(s)
| | - Jack D. Sobel
- Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan USA
| | - Marc Ouellette
- Canada Research Chair in Antimicrobial Resistance, Centre de recherche en Infectiologie, University of Laval, Quebec City, Canada
| | - Keith S. Kaye
- Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan USA
| | - Dror Marchaim
- Infection Control and Prevention Unit of Infectious Diseases, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Sader HS, Rhomberg PR, Castanheira M, Farrell DJ, Flamm RK, Mendes RE, Jones RN. Ceftaroline activity tested against viridans group streptococci from US hospitals. Diagn Microbiol Infect Dis 2016; 84:232-5. [PMID: 26658313 DOI: 10.1016/j.diagmicrobio.2015.10.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 01/18/2023]
Abstract
A total of 840 clinically relevant viridans group streptococci (VGS) isolates (1/patient episode) were collected from 71 US medical centers in 2013-2014. These organisms were tested for susceptibility by reference broth microdilution methods against ceftaroline and selected comparator agents. All isolates were speciated by matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) mass spectrometry and were primarily from skin/soft tissue (32.6%) and bloodstream (32.3%) infections. Ceftaroline was highly active against all VGS species/groups with MIC50 and MIC90 values ranging from ≤0.015 to 0.03μg/mL and ≤0.015 to 0.06μg/mL, respectively. The highest ceftaroline MIC value was only 0.5μg/mL (0.5% of strains) and ceftaroline (MIC50/90, 0.03/0.06μg/mL) was 8-fold more active than ceftriaxone (MIC50/90, 0.25/0.5μg/mL). The VGS groups most susceptible to ceftaroline were Streptococcus mutans and Streptococcus bovis (MIC90, ≤0.015μg/mL), whereas the highest ceftaroline MIC values were observed among Streptococcus mitis and Streptococcus sanguinis groups. In summary, ceftaroline exhibited potent in vitro activity against VGS, including many uncommonly isolated species/groups for which very limited susceptibility information is currently available to guide therapy.
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Fabre V, Ferrada M, Buckel WR, Avdic E, Cosgrove SE. Ceftaroline in Combination With Trimethoprim-Sulfamethoxazole for Salvage Therapy of Methicillin-Resistant Staphylococcus aureus Bacteremia and Endocarditis. Open Forum Infect Dis 2014; 1:ofu046. [PMID: 25734118 PMCID: PMC4281789 DOI: 10.1093/ofid/ofu046] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/09/2014] [Indexed: 11/15/2022] Open
Abstract
No clinical trials have investigated the use of ceftaroline fosamil for salvage therapy of methicillin-resistant Staphylococcus aureus bacteremia and endocarditis. We report data on 29 patients who received ceftaroline ± another antimicrobial for this indication. Ninety percent of patients had microbiologic cure and 31% had treatment success with a median follow-up of 6 months.
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Affiliation(s)
- Valeria Fabre
- Division of Infectious Diseases , Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Marcela Ferrada
- Division of Infectious Diseases , Johns Hopkins University School of Medicine , Baltimore, Maryland ; Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland
| | - Whitney R Buckel
- Department of Pharmacy , Intermountain Medical Center , Murray, Utah
| | - Edina Avdic
- Department of Pharmacy , Johns Hopkins Hospital , Baltimore, Maryland
| | - Sara E Cosgrove
- Division of Infectious Diseases , Johns Hopkins University School of Medicine , Baltimore, Maryland
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