Epidemiology of Vancomycin-Resistant Enterococci with Reduced Susceptibility to Daptomycin

Judge, Theresa; Pogue, Jason M.; Marchaim, Dror; Ho, Kevin; Kamatam, Srinivasa; Parveen, Shakila; Tiwari, Namita; Nanjireddy, Priyanka; Bheemreddy, Suchitha; Biedron, Caitlin; Reddy, Sagar Mallikethi Lepakshi; Khammam, Vijaykumar; Chalana, Indu K.; Tumma, Rajachendra Shekher; Collins, Vicki L.; Yousuf, Adnan; Lephart, Paul; Martin, Emily T.; Rybak, Michael J.; Kaye, Keith S.; Hayakawa, Kayoko

doi:10.1086/668438

Cited by 24 publications

(20 citation statements)

References 6 publications

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“…and de novo acquisition of DNSE in a susceptible host. Previous data are consistent with both pathways being clinically relevant (6, 7, 12). Although we did not perform epidemiologic typing and VRE colonization rates were similar in patients with DNSE f and DSE f , we speculate that differences in local flora and our heavily immunosuppressed patient population, primarily with relapsed leukemia, predispose our patients to the development of DNSE in the setting of prolonged daptomycin exposure.…”

Section: Discussionsupporting

confidence: 76%

Daptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure

DiPippo

Tverdek

Tarrand

et al. 2017

Journal of Infection

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Summary Objectives We sought to determine the association between previous daptomycin exposure and daptomycin non-susceptible Enterococcus faecium (DNSEf) bloodstream infections (BSI) in adult leukemia patients. Methods We retrospectively identified adult (≥ 18 years old) leukemia patients with Enterococcus spp. bacteremia at The University of Texas MD Anderson Cancer Center (MDACC) from 6/1/2013 to 7/22/2015. Antimicrobial susceptibility and previous antibiotic exposure within the 90 days prior to bacteremia were collected. Classification and Regression Tree (CART) analysis was used to identify the most significant breakpoint between daptomycin exposure and DNSEf. Results Any amount of daptomycin received within the 90 days preceding BSI was significantly associated with isolation of DNSEf compared to daptomycin susceptible E. faecium (DSEf) (88% vs. 44%, respectively, p<0.01). CART analysis identified receiving ≥ 13 days of daptomycin in the preceding 90 days as most significantly correlated with DNSEf (60% vs. 11%, relative risk [RR] 5.31, 95% Confidence interval [CI] 2.36–11.96, p < 0.01). Conclusions Prior daptomycin exposure for ≥ 13 days within 90 days preceding BSI was significantly associated with isolation of DNSEf BSI in adult leukemia patients at our institution. Antimicrobial stewardship initiatives aimed at minimizing daptomycin exposure in high-risk patients may be of significant benefit in limiting the emergence of DNSEf.

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Section: Discussionsupporting

confidence: 76%

Daptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure

DiPippo

Tverdek

Tarrand

et al. 2017

Journal of Infection

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“…Our findings in 42 DNSE clinical isolates from patients of a tertiary medical center in suburban New York City, together with those of several recent studies from other U.S. institutions (14)(15)(16)(17)(18)(19), demonstrate the emergence and spread of DNSE in the U.S. health care setting. However, there are only limited data available on the population genetics of DNSE isolates.…”

Section: Discussionsupporting

confidence: 76%

“…Daptomycin-nonsusceptible enterococci, however, are emerging as a cause of health careassociated infection (4,6) and may be fairly common; they comprised 3.9% of 2,029 Enterococcus faecium isolates from U.S. hospitals over the period 2007 to 2010 (13) and 15.2% among VRE blood isolates at a New York cancer center (14). In addition to some earlier case reports (reviewed in reference 4), a notable increase in the number of patients infected or colonized with daptomycin-nonsusceptible enterococci has been reported from different geographic regions in the United States (14)(15)(16)(17)(18)(19).…”

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confidence: 94%

“…De novo resistance is also reported for some patients without prior use of daptomycin (16,22). The results of a recent case-control study suggested that immunosuppression, the presence of comorbid conditions, and prior exposure to antimicrobials are independent predictors of infections caused by daptomycin-nonsusceptible enterococci (17). The mechanism of daptomycin resistance in enterococci, especially in E. faecium, remains to be fully elucidated.…”

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confidence: 99%

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Identification of a Novel Clone, ST736, among Enterococcus faecium Clinical Isolates and Its Association with Daptomycin Nonsusceptibility

Wang

Kamalakaran

Dhand

et al. 2014

Antimicrob Agents Chemother

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Resistance to daptomycin in enterococcal clinical isolates remains rare but is being increasingly reported in the United States and worldwide. There are limited data on the genetic relatedness and microbiological and clinical characteristics of daptomycinnonsusceptible enterococcal clinical isolates. In this study, we assessed the population genetics of daptomycin-nonsusceptible Enterococcus faecium (DNSE) clinical isolates by multilocus sequence typing (MLST) and whole-genome sequencing analysis. Forty-two nonduplicate DNSE isolates and 43 randomly selected daptomycin-susceptible E. faecium isolates were included in the analysis. All E. faecium isolates were recovered from patients at a tertiary care medical center in suburban New York City from May 2009 through December 2013. The daptomycin MICs of the DNSE isolates ranged from 6 to >256 g/ml. Three major clones of E. faecium (ST18, ST412, and ST736) were identified among these clinical isolates by MLST and whole-genome sequence-based analysis. A newly recognized clone, ST736, was seen in 32 of 42 (76.2%) DNSE isolates and in only 14 of 43 (32.6%) daptomycin-susceptible E. faecium isolates (P < 0.0001). This report provides evidence of the association between E. faecium clone ST736 and daptomycin nonsusceptibility. The identification and potential spread of this novel E. faecium clone and its association with daptomycin nonsusceptibility constitute a challenge for patient management and infection control at our medical center.

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“…The emergence of the glycopeptide resistance is of great concern in treatment of gram positive infections particluarly MRSA/VISA/VRSA/GISA. Several other studies have also demonstrated reduced susceptibility of MRSA against glycopeptide and lipopeptide (Estes and Derendorf, 2010; Judge et al, 2012). The reduced susceptibility of glycopeptide is due to trapping of glycopeptide in the peptidoglycan of the bacterial cell, thus allowing decreased number of glycopeptide reaching the cytoplasmic membrane where the targets of glycopeptides are located (Westerlind, 2012).…”

Section: Discussionmentioning

confidence: 94%

PREVALENCE OF HETEROGENEOUS GLYCOPEPTIDE INTERMEDIATE RESISTANCE IN METHICILLIN-RESISTANT <i>STAPHYLOCOCCUS AUREUS</i>

Chaudhary¹

2013

American Journal of Infectious Diseases

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Multidrug resistant Methicillin-Resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community acquired infections and is on the rise. The aim of this investigation was to explore the prevalence of MRSA and heterogeneous Glycopeptide Intermediate Staphylococcus aureus (hGISA) in various clinical samples, to investigate the various antibiotic resistant determinant genes among these strains collected from north and west Indian hospitals and to evaluate the response of various drugs to these strains. A total of 413 clinical specimens collected from different hospitals were processed for the screening of S. aureus and MRSA. All the MRSA strains were further screened for hGISA on Mueller-Hinton agar containing 8 µg mL −1 teicoplanin or 6 µg mL −1 vancomycin. hGISA confirmed by the E-test method with a dense inoculum and a simplified method of population analysis. Susceptibility study was conducted according to the Clinical and Laboratory Standards Institute (CLSI) methods. Among 211/413 S. aureus clinical isolates, 61.6% (130/211) of the isolates were confirmed to be MRSA which included maximum isolates from pus, blood, urine, wound swab and ear swab samples in decreasing order. hGISA strains were found in 8/130 (6.1%) isolates. Vancoplus, a novel antibiotic adjuvant entity was found to be susceptible in 96.1 to 97.8% MRSA strains and showed intermediate response in 2.2 to 3.8% of isolates. Linezolid appeared to be second most active antibiotic with 48.0 to 81.2% susceptibility, followed by teicoplanin (41.3 to 56.2% susceptibility). There was 8.7 to 9.6% resistance observed in Linezolid which was increased to 48% in teicoplanin, to >60% in daptomycin and >75% in vancomycin. Interestingly, none of the isolates were susceptible to ceftriaxone and cefoperazone plus sulbactam. From the above study it can be concluded that prevelance of MRSA has reached a significant level and Vancoplus is the most effective drug in MRSA as well as hGISA organisms in comparison to comparator drugs.

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Epidemiology of Vancomycin-Resistant Enterococci with Reduced Susceptibility to Daptomycin

Cited by 24 publications

References 6 publications

Daptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure

Daptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure

Identification of a Novel Clone, ST736, among Enterococcus faecium Clinical Isolates and Its Association with Daptomycin Nonsusceptibility

PREVALENCE OF HETEROGENEOUS GLYCOPEPTIDE INTERMEDIATE RESISTANCE IN METHICILLIN-RESISTANT <i>STAPHYLOCOCCUS AUREUS</i>

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