Impact of EUCAST ceftaroline breakpoint change on the susceptibility of methicillin-resistant Staphylococcus aureus isolates collected from patients with complicated skin and soft-tissue infections

Abstract

Editor: F. Allerberger Keywords: Breakpoint Ceftaroline Complicated skin and soft-tissue infections EUCAST Methicillin-resistant Staphylococcus aureus a b s t r a c t Objectives: In 2018, the European Committee on Antimicrobial Susceptibility Testing (EUCAST) introduced an intermediate breakpoint for ceftaroline against Staphylococcus aureus. The objective of this study was to compare data on resistance to ceftaroline among methicillin-resistant S. aureus (MRSA) isolates using versions 7.1 (March 2017) and 8.0 (January 2018) of the EUCAST breakpoints. Methods: Participating centers were located in Africa, Asia, Europe, Oceania and South America. Isolates were collected from patients with complicated skin and soft-tissue infections and were cultured from integumentary sources. Methicillin resistance among S. aureus was confirmed locally using the oxacillin method. The CLSI broth microdilution method was used to measure ceftaroline MICs at the central laboratory. Versions 7.1 and 8.0 of the EUCAST breakpoints were used to interpret MIC data. Results: Between 2015 and 2016, 9559 isolates of S. aureus were collected, of which 5566 (58.2%) isolates were MRSA. Overall, the lowest rate of MRSA was in Asia (56.5%; 705/1247) and the highest rate was in Oceania (62.7%; 299/477). Using version 7.1 of the EUCAST breakpoints, 4.5% (250/5566) of all MRSA isolates were resistant to ceftaroline and when version 8.0 of the breakpoints was applied, 4.2% (235/5566) of MRSA were in the intermediate category and 0.3% (15/5566) of all isolates were considered resistant. Conclusions: By applying version 8.0 of the EUCAST breakpoints, the majority of MRSA isolates that were resistant are now in the intermediate category for ceftaroline. Ceftaroline resistance among MRSA now appears rare. E. Urb an, Clin Microbiol Infect 2019;25:1429.e1e1429.e4

Genome-Wide Association Studies for the Detection of Genetic Variants Associated With Daptomycin and Ceftaroline Resistance in Staphylococcus aureus

“…Isolates have been further characterized by spa typing as described previously ( Strommenger et al, 2008 ). Since DAP and CPT resistance in S. aureus is still rare ( Roch et al, 2017 ; Urban and Stone, 2019 ), the sample sizes remained comparatively small ( Power et al, 2017 ). A total of 48 daptomycin resistant (DAP-R) and 47 daptomycin susceptible (DAP-S) S. aureus isolates were selected according to Robert and Weber (2017) .…”

The Continuing Threat of Methicillin-Resistant Staphylococcus aureus

“…Ceftaroline (Teflaro ® [US], Zinforo ® [EU]; 600 mg/12 h) and ceftobiprole (Zevtera ® [US], Mabelio ® [EU]; 500 mg/8 h) are broad-spectrum cephalosporins with pronounced bactericidal activity against MRSA, VISA, daptomycin-resistant S. aureus, and vancomycin-resistant E. faecalis [154,155,156,157,158,159,160,161]. For this reason, they are sometimes termed anti-MRSA cephalosporins, or fifth generation cephalosporins [49,79].…”

The use of extrapolation based on modeling and simulation to support high‐dose regimens of ceftaroline fosamil in pediatric patients with complicated skin and soft‐tissue infections

“…10,11 Although most S. aureus clinical isolates have ceftaroline MIC ≤1 mg/L, surveillance data have identified MRSA isolates with MICs of 2 or 4 mg/L in various regions. 13,15,18,19 In 2015-2016, the overall percentages of MRSA isolates with MIC >1 mg/L from SSTI clinical specimens were 1.0% (Oceania), 3.1% (Europe), 3.8% (Africa), 7.6% (South America), and 7.8% (Asia). 18 In United States surveillance from 2010-2016, 2.8% of MRSA clinical isolates had ceftaroline MIC >1 mg/L.…”

“…10,11 This regimen provides adequate exposure and pharmacokinetic/pharmacodynamic (PK/PD) target attainment for patients with cSSTI caused by S. aureus with ceftaroline minimum inhibitory concentration (MIC) ≤1 mg/L, 9 which comprise the vast majority of S. aureus clinical isolates in contemporary global surveillance studies. [13][14][15][16][17][18][19] Ceftaroline fosamil standard-dose…”