1
|
Aljohani S, Layqah L, Masuadi E, Al Alwan B, Baharoon W, Gramish J, Baharoon S. Occurrence of vancomycin MIC creep in methicillin resistant isolates in Saudi Arabia. J Infect Public Health 2020; 13:1576-1579. [PMID: 32859551 DOI: 10.1016/j.jiph.2020.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/16/2020] [Accepted: 07/13/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND "MIC creep" is a phenomenon that describes an increase of an organism MICs over time and have been reported from different parts of the world. High MIC in MRSA has been theoretically liked to treatment failure and may be a precursor to hVISA and VISA. This study was conducted to assess presence of vancomycin minimum inhibitory concentration (MIC) creeps among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) in Saudi Arabia. METHODS Minimum inhibitory concentration (MIC) of vancomycin by E test of all MRSA isolates of from 2013 to 2018 were reviewed. RESULTS Of the 736 isolates evaluated, no isolates with MIC above 2 were found. Majority of MRSA isolates were susceptible to vancomycin with MIC less than 1. There was a significant increase in both Arithmetic and geometric mean MIC for vancomycin during the first three years which progressively declined in the next three years. CONCLUSIONS Although most of MRSA isolated remained very susceptible to vancomycin there was evidence of dynamic vancomycin MIC creep over time.
Collapse
Affiliation(s)
- Sameerah Aljohani
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Laila Layqah
- Department of Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Emad Masuadi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bassam Al Alwan
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Waleed Baharoon
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Salim Baharoon
- Department of Intensive Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
2
|
Khurana S, Mathur P, Malhotra R. Staphylococcus aureus at an Indian tertiary hospital: Antimicrobial susceptibility and minimum inhibitory concentration (MIC) creep of antimicrobial agents. J Glob Antimicrob Resist 2018; 17:98-102. [PMID: 30389637 DOI: 10.1016/j.jgar.2018.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 10/02/2018] [Accepted: 10/19/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Staphylococcus aureus causes a variety of symptoms and diseases and has been associated with high morbidity and mortality. A global population drift in clinical S. aureus isolates towards reduced antimicrobial susceptibility is being reported. In this study, the antimicrobial susceptibility profile and minimum inhibitory concentration (MIC) creep of vancomycin, linezolid, teicoplanin and rifampicin against clinical S. aureus isolates at an Indian tertiary centre from January 2012 to December 2016 were investigated. METHODS All consecutive, non-duplicate S. aureus isolates (n=1466) recovered from hospitalised patients identified by VITEK®2 were included in the study. Clinical isolates were tested against 20 antibiotics and were evaluated according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical significance of the MIC creeps of four antimicrobials (vancomycin, linezolid, teicoplanin and rifampicin) was ascertained. RESULTS S. aureus isolates recovered from all clinical samples demonstrated high resistance to ampicillin, ciprofloxacin and penicillin (75-100%) and low resistance to amikacin, linezolid, netilmicin, nitrofurantoin, teicoplanin and vancomycin (0-13%). The MIC90 values (MIC required to inhibit 90% of the isolates) for vancomycin, linezolid and rifampicin decreased, whereas the MIC90 for teicoplanin increased. The change in the geometric mean MIC of rifampicin was found to be statistically significant. A statistically significant and progressive MIC creep was observed for teicoplanin and rifampicin. CONCLUSION Despite remaining susceptible, S. aureus is not inert to antibiotic pressure. Implementation of preventive measures in healthcare settings is required worldwide to combat the increasing number of infections by this pathogen.
Collapse
Affiliation(s)
- Surbhi Khurana
- Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Purva Mathur
- Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Rajesh Malhotra
- Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India
| |
Collapse
|
3
|
Jiang B, Yin S, You B, Huang G, Yang Z, Zhang Y, Chen Y, Chen J, Yuan Z, Rao X, Hu X, Gong Y, Peng Y. A 5-year Survey Reveals Increased Susceptibility to Glycopeptides for Methicillin-Resistant Staphylococcus aureus Isolates from Staphylococcus aureus Bacteremia Patients in a Chinese Burn Center. Front Microbiol 2017; 8:2531. [PMID: 29312223 PMCID: PMC5735371 DOI: 10.3389/fmicb.2017.02531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 12/05/2017] [Indexed: 12/13/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infections are prevalent in burn wards, and are especially serious in S. aureus bacteremia (SAB) patients. Glycopeptides and daptomycin are effective against MRSA infections, but MIC creeps can reduce their efficacy. Our object was to perform a molecular epidemiological investigation of S. aureus isolates in our burn center and to evaluate MICs for antimicrobials against SAB-associated MRSA isolates. A total of 259 S. aureus isolates, obtained from August 2011 to July 2016, were used in this study. Multiple molecular typing was used for molecular epidemiological analysis. E-tests were used to determine MICs of vancomycin, teicoplanin, and daptomycin for SAB-associated MRSA isolates. MIC values were stratified by collection date or source and compared. Spearman's test was used to analyze MICs correlations amongst tested antimicrobials. ST239-MRSA-III-t030-agrI clone was found to be dominant in both SAB and non-SAB patients, and significantly more in SAB patients (P < 0.0001). SAB-MRSA isolates exhibited decreased MICs for vancomycin, teicoplanin, and daptomycin during the 5-year period. Compared to those isolated from catheters or wounds, SAB-MRSA isolates from the bloodstream were less susceptible to vancomycin and daptomycin, but more susceptible to teicoplanin. MICs Correlation was found only between vancomycin and daptomycin in MRSA isolates from the bloodstream (rho = 0.250, P = 0.024). In conclusion, our results suggest that MRSA infections are still serious problems in burn centers. In contrast to most other studies, we observed increased susceptibility to glycopeptides and daptomycin against SAB-associated MRSA in our center from 2011 to 2016, suggesting the use of glycopeptides does not lead to MIC creeps. Isolates from different sites of the body may exhibit different levels of susceptibility and change trend over time for different antimicrobials, antimicrobials selection for MRSA infections should be considered comprehensively.
Collapse
Affiliation(s)
- Bei Jiang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Supeng Yin
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Bo You
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Guangtao Huang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Zichen Yang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yulong Zhang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yu Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jing Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Zhiqiang Yuan
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiancai Rao
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China
| | - Xiaomei Hu
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China
| | - Yali Gong
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yizhi Peng
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China
| |
Collapse
|
4
|
Diaz R, Ramalheira E, Afreixo V, Gago B. Evaluation of vancomycin MIC creep in Staphylococcus aureus. J Glob Antimicrob Resist 2017; 10:281-284. [PMID: 28751240 DOI: 10.1016/j.jgar.2017.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Vancomycin is the primary treatment for methicillin-resistant Staphylococcus aureus (MRSA). However, an increasing proportion of MRSA isolates with high minimum inhibitory concentrations (MICs) within the susceptible range (vancomycin 'MIC creep') is being observed. The aim of this study was to assess the vancomycin MIC distribution for S. aureus isolates over a period of 4 years in Centro Hospitalar Baixo Vouga (Aveiro, Portugal) and to identify differences in vancomycin MIC determined by different susceptibility testing methods. METHODS For each S. aureus isolate, the vancomycin MIC was assayed by the VITEK®2 automated system and the broth microdilution testing method. RESULTS The results showed significant differences in vancomycin MIC by different methods (P=0.021, sign test) and did not suggest the presence of vancomycin MIC creep during the study period. CONCLUSIONS Vancomycin MIC creep is a regional problem, therefore it can only be assessed through the evaluation of local susceptibility profiles, and antibiogram based on real MIC assay should be an essential element in local MRSA infection clinical management.
Collapse
Affiliation(s)
- Raquel Diaz
- Health Sciences Department, University of Aveiro, 3810-193 Aveiro, Portugal; Institute for Research in Biomedicine (iBiMED), Health Sciences Program, University of Aveiro, 3810-193 Aveiro, Portugal; Department of Medical Microbiology, Centro Hospitalar Baixo Vouga, Av. Artur Ravara, 3814-501 Aveiro, Portugal.
| | - Elmano Ramalheira
- Health Sciences Department, University of Aveiro, 3810-193 Aveiro, Portugal; Department of Medical Microbiology, Centro Hospitalar Baixo Vouga, Av. Artur Ravara, 3814-501 Aveiro, Portugal
| | - Vera Afreixo
- Health Sciences Department, University of Aveiro, 3810-193 Aveiro, Portugal; Institute for Research in Biomedicine (iBiMED), Health Sciences Program, University of Aveiro, 3810-193 Aveiro, Portugal; Department of Mathematics, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Bruno Gago
- Health Sciences Department, University of Aveiro, 3810-193 Aveiro, Portugal; Institute for Research in Biomedicine (iBiMED), Health Sciences Program, University of Aveiro, 3810-193 Aveiro, Portugal
| |
Collapse
|
5
|
Singh A, Prasad KN, Rai RP, Singh SK, Rahman M, Tripathi A, Srivastava JK. Glycopeptide and daptomycin susceptibility trends among clinical isolates of methicillin-resistant Staphylococcus aureus in a tertiary care center in North India. J Infect Public Health 2015; 8:341-5. [PMID: 25797814 DOI: 10.1016/j.jiph.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/31/2014] [Accepted: 02/13/2015] [Indexed: 11/17/2022] Open
Abstract
Increased vancomycin minimum inhibitory concentration (MIC) levels in Staphylococcus aureus and their association with vancomycin treatment failure are well-known problems. Few studies have recognized progressive increases in glycopeptide MIC levels for S. aureus strains in recent years. This study determined glycopeptide and daptomycin susceptibility among methicillin resistant S. aureus (MRSA) strains. A total of 776 clinical isolates of MRSA recovered from 2009 to 2012 were studied for glycopeptide and daptomycin susceptibility using the E-test method. The vancomycin MIC geometric mean (GM) of the MRSA isolates was 0.923, 0.944, 1.134 and 1.294 mg/L in the years 2009, 2010, 2011 and 2012, respectively, and the trend significantly increased over the years (P < 0.0001). Similarly, the teicoplanin MIC GM was 1.47, 1.49, 1.8 and 2.04 mg/L in the years from 2009 to 2012, respectively (P < 0.0001). MIC shifts were not found for daptomycin (P > 0.232). A significant increase in the MIC for glycopeptides was observed among the clinical MRSA isolates at our center over a 4-year period. However, the daptomycin MIC did not increase in the observed MRSA isolates.
Collapse
Affiliation(s)
- Avinash Singh
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; Amity Institute of Biotechnology, Amity University Uttar Pradesh, Lucknow, Uttar Pradesh, India
| | - Kashi N Prasad
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Ravi P Rai
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Satyendra K Singh
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Mohibur Rahman
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Aparna Tripathi
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Janmejai K Srivastava
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Lucknow, Uttar Pradesh, India
| |
Collapse
|