Worrisome trends in rising minimum inhibitory concentration values of antibiotics against methicillin resistant Staphylococcus aureus – Insights from a tertiary care center, South India

Nagasundaram, N.; Sistla, Sujatha

doi:10.1016/j.bjid.2015.08.005

Cited by 14 publications

(12 citation statements)

References 19 publications

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“…[ 8 9 ] For decades, vancomycin was the mainstay in the treatment of infections caused by MRSA. However, recently, large number of literature has populated with vancomycin creep,[ 1 2 3 ] where treatment failure has been observed with increased MIC of vancomycin within susceptible zone. CLSI has reduced the vancomycin susceptible breakpoint for S. aureus from 4 μg/ml to 2 μg/ml in 2006.…”

Section: Discussionmentioning

confidence: 99%

“…Increased use of vancomycin has resulted in the emergence of MRSA with reduced susceptibility to vancomycin. [ 1 2 3 ] Emergence of vancomycin intermediate or resistant S. aureus has created the need for other anti-MRSA antibiotics. Many alternatives for treatment of MRSA infection including linezolid and daptomycin are currently approved by Food and Drug Administration.…”

Section: Introductionmentioning

confidence: 99%

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Vancomycin, linezolid and daptomycin susceptibility pattern among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) from Sub- Himalyan Center

et al. 2018

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INTRODUCTION: The efficacy of vancomycin, drug of choice for methicillin-resistant Staphylococcus aureus (MRSA), has become questionable due to the emergence of MRSA isolates with reduced susceptibility. The present study was conducted to determine the vancomycin, linezolid, and daptomycin susceptibility pattern in clinical isolates of MRSA and to observe minimum inhibitory concentration (MIC) creep over 2 years if any. MATERIALS AND METHODS: MIC of vancomycin, linezolid, and daptomycin were determined by E-test in 198 MRSA isolates and their MIC 50, MIC 90, and geometric mean MIC were calculated. RESULTS: While all isolates were sensitive to vancomycin, linezolid, and daptomycin, MIC 90 of vancomycin increased from 1.5 µg/ml in 2015 to 2 µg/ml in 2016. The percentage of isolates with vancomycin MIC >2 µg/ml doubled in 2016 (12.9%) as compared to 2015 (6.1%). MIC 90 for linezolid remained steady as 3 µg/ml, but geometric mean MIC increased from 2.20 µg/ml in 2015 to 2.29 µg/ml in 2016, and more than 40% isolates showed MIC 3 µg/ml. MIC 90 and geometric mean MIC of daptomycin decreased from 0.75 µg/ml to 0.5 µg/ml and 0.50 µg/ml to 0.36 µg/ml in 2015 and 2016, respectively. CONCLUSION: MIC creep was observed with vancomycin. Although linezolid MIC was within the susceptible zone, more than 40% strains showing MIC 3 µg/ml may herald the future development of either resistant or heteroresistant. Daptomycin showed good sensitivity against MRSA isolates. Therefore, it could be considered as an alternative agent for the treatment of infections caused by MRSA. However, it should be reserved where this class has a clear therapeutic advantage over other anti-MRSA drugs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vancomycin, linezolid and daptomycin susceptibility pattern among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) from Sub- Himalyan Center

et al. 2018

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“…Beyond its high virulence, MRSA is also notorious for its emerging vancomycin resistance (Lai et al, 2015; Teh et al, 2015). Recently, there has been increasing evidence supporting the poor efficacy of vancomycin in treating MRSA infections due to rising vancomycin MICs in clinical MRSA isolates, increasing from 0.25 to 2.0 μg/mL (Hawser et al, 2011; Chang et al, 2015; Niveditha and Sujatha, 2015). Therefore, several combination regimens, including rifampicin- or fosfomycin-based combinations, have been proposed to overcome the therapeutic disadvantage of vancomycin (Perlroth et al, 2008; Tang et al, 2011, 2012, 2013).…”

Section: Introductionmentioning

confidence: 99%

Cephalosporin-Glycopeptide Combinations for Use against Clinical Methicillin-Resistant Staphylococcus aureus Isolates: Enhanced In vitro Antibacterial Activity

et al. 2017

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The empirical combination of both a beta-lactam and glycopeptide to counter potential staphylococcal pathogens may improve the clinical outcomes for cases of Staphylococcus aureus bacteremia. We reported comparative in vitro studies of combination effects of different cephalosporins (i.e., cefazolin, cefmetazole, cefotaxime, and cefepime) combined with glycopeptides for 34 randomly selected methicillin-resistant S. aureus (MRSA) isolates by three methods, including the checkerboard, time-killing, and combination MIC measurement methods. Thirteen SCCmec type III isolates with a cefazolin MIC of ≥ 128 μg/mL were classified as the high-cefazolin MIC (HCM) group, whereas 13 SCCmec type IV and 8 SCCmec type V isolates were classified as the low-cefazolin MIC (LCM) group. With the checkerboard method, synergism was present for vancomycin-based combinations at 30.8–69.2 and 13.6–66.7%, as well as teicoplanin-based combinations of 38.5–84.6 and 0–47.6%, of the HCM and LCM isolates, respectively. No antagonism was noted. The in vitro inhibitory activity was evident even at a low concentration of 1/512x MIC of cephalosporin combined with sub-inhibitory concentrations (1/2x MIC) of a glycopeptide. With time-killing assays, synergism was noted at 1/2x or 1x susceptible breakpoint concentrations (SBCs) of a cephalosporin combined with 1/4 or 1/2 MIC of a glycopeptide. In the presence of 1/2 SBC of a cephalosporin, vancomycin or teicoplanin MICs decreased an average of 2.0- to 6.6- or 1.6- to 5.5-fold, respectively. With 8 μg/mL cephalosporin, the decline of glycopeptide MICs was most obvious in the presence of cefmetazole. In conclusion, cephalosporin-glycopeptide combinations at clinically achievable concentrations can exhibit in vitro synergistic antibacterial activity against clinical MRSA isolates. Such combinations require more clinical data to support their application for use in human MRSA infections.

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“…The multidrugresistant (MDR) capacity of S. aureus, especially healthcareassociated methicillin-resistant S. aureus (HA-MRSA), coupled with concerns regarding the adequacy of vancomycin in treating complicated staphylococcal infections has prompted the development of several new agents with potent activity against MRSA, methicillin-susceptible S. aureus (MSSA), and MDR MRSA, including strains with elevated vancomycin MIC values [1][2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…aureus continues to be a leading cause of septicemia, osteoarticular infections, skin and skin structure infections (SSSI), pleuropulmonary infections, and device-related infections [1,8]. Whereas infection rates from MRSA appear to have stabilized or even decreased in industrialized countries, concerns regarding suboptimal responses to glycopeptides, the slow bactericidal activity of vancomycin, the emergence of isolates with reduced susceptibility to vancomycin and daptomycin on therapy, and possible MIC creep among susceptible isolates complicate managing S. aureus infections [1,3,4,6,7,9,10].…”

Section: Introductionmentioning

confidence: 99%

Telavancin Activity Against a Global Collection of Staphylococcus aureus Clinical Isolates (2013–2015)

Ma¹,

Mendes²,

Sader³

et al. 2017

J Infec Dis Treat

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Telavancin had MIC 50 , MIC 90 , and MIC 100 values of 0.03, 0.06, and 0.12 μg/mL, respectively, against methicillinsusceptible (MSSA), methicillin-resistant (MRSA), and MRSA multidrug-resistant (MDR) subsets of Staphylococcus aureus. Isolates with elevated vancomycin MIC values (2 μg/mL) resulted in a telavancin MIC 50 (0.06 μg/mL) 2-fold higher than isolates with lower vancomycin MIC results (telavancin MIC 50 , 0.03 μg/mL). However, telavancin had MIC 90 and MIC 100 results of 0.06 and 0.12 μg/mL (100% susceptible), respectively, regardless of methicillin-resistance phenotype.

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Worrisome trends in rising minimum inhibitory concentration values of antibiotics against methicillin resistant Staphylococcus aureus – Insights from a tertiary care center, South India

Abstract: MIC creep was notably observed with vancomycin, and to some extent with tigecycline and linezolid. Selection pressure may result in creeping MICs, which may herald the emergence of resistant organisms.

Cited by 14 publications

References 19 publications

Vancomycin, linezolid and daptomycin susceptibility pattern among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) from Sub- Himalyan Center

Vancomycin, linezolid and daptomycin susceptibility pattern among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) from Sub- Himalyan Center

Cephalosporin-Glycopeptide Combinations for Use against Clinical Methicillin-Resistant Staphylococcus aureus Isolates: Enhanced In vitro Antibacterial Activity

Telavancin Activity Against a Global Collection of Staphylococcus aureus Clinical Isolates (2013–2015)

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