Nationwide surveillance of resistance rates ofStaphylococcus aureusclinical isolates from Greek hospitals, 2012–2013

Abstract

Purpose To evaluate the in vitro efficacy of several anti-staphylococcal agents against a nationwide collection of contemporary Staphylococcus aureus clinical isolates from several healthcare centres in Greece. Methods Thirty hospitals throughout Greece (18 in Attica) provided all clinical isolates of S.aureus from April 2012 to May 2013 to a central lab to be re-submitted to susceptibility testing. The MICs were evaluated by Vitek® 2 with the exception of ceftaroline (OXOID M.I.C. Evaluator™). Vancomycin and daptomycin MICs were also evaluated by Etest®. Heterogeneously vancomycin-intermediate strains (hVISA) were detected by the Etest® GRD. VISA phenotype was confirmed by PAP-AUC. Results A total of 1005 isolates (39% MRSA) were studied. Susceptibility rates were: erythromycin 66.5%, clindamycin 79.2%, SXT 98.9%, rifampicin 97.3%, fusidic acid 67%, moxifloxacin 78.8%, vancomycin 99.9%, ceftaroline 92.9% and linezolid, tigecycline and daptomycin 100%. For mupirocin, high level resistance could be excluded for 98.9% of isolates. Vancomycin Etest® MIC were 1.5/1.5 mg/L, 58.5% of isolates exhibited a MIC > 1 and 8.7% a MIC of 2 mg/L, while Vitek® MIC were 1/1 and 3.1% showed MIC > 1 mg/L. One VISA strain was detected. Among the selected 175 isolates that were screened for hVISA phenotype, six (3.4%) were positive. In 315 bloodstream isolates, 64.1% had a vancomycin Etest® MIC > 1 mg/L. Conclusions This multi-centre surveillance study revealed that a significant percentage of contemporary S.aureus isolates from Greek patients have a vancomycin MIC (> 1 mg/L) that may compromise the clinical efficacy of the drug for the treatment of serious infections. The in vitro activity of SXT, rifampicin, mupirocin, linezolid, tigecycline, daptomycin and ceftaroline remains excellent.

Six-Year Retrospective Review of Hospital Data on Antimicrobial Resistance Profile of Staphylococcus aureus Isolated from Skin Infections from a Single Institution in Greece

“…We found increased resistance for clindamycin (18%) but low for STX (4.6%), however 38% and 12.5% of MRSA isolates were resistant to clindamycin and STX, respectively. Our results are similar for clindamycin but much higher for STX compared with previous studies in Greek hospitals [ 12 , 18 , 19 ]. The high resistance to clindamycin limits its use for SSTI but STX may still be an option.…”

“…Global MRSA rates vary from 26–30% in Africa, Europe and the Middle East to 50% in North America and 55% in Latin America, significantly decreasing overall between 2004 and 2014 [ 7 ]. In Greece, where antimicrobial drug resistance remains high, MRSA prevalence reaches 40%, which is among the highest in Europe [ 8 , 9 , 10 , 11 , 12 ]. However, in a multicenter European study investigating MRSA infections among patients in the emergency department, lower MRSA rates (27%) from Greece were reported, compatible with our results [ 13 ].…”

Molecular analysis, biofilm formation, and susceptibility of methicillin-resistant Staphylococcus aureus strains causing community- and health care-associated infections in central venous catheters

“…Among macrolides, erythromycin resistance was observed in 96% of cases and ciprofloxacin resistance in 98% of MRSA isolates, which agrees with studies conducted in Japan 48,49 . The same studies showed different resistance to SXT (2%) and clindamycin (90%) because of the use of antibiotics in different settings 50,51 . Variable resistance to fusidic acid was reported previously, and some reports showed the same resistance found in this study 52 .…”

CURRENT SENSITIVITY PATTERN OF MRSA (METHICILLIN RESISTANT STAPH AUREUS) IN A TERTIARY CARE ORTHOPAEDIC HOSPITAL IN KASHMIR (J&K)

“…A recent multi-centre study from Greek revealed vancomycin sensitivity of 99.9%, however Vancomycin Etest® MIC50/90 were 1.5/1.5 mg/L, 58.5% of isolates exhibited an MIC > 1 and 8.7% an MIC of 2mg/L, while Vitek® MIC50/90 were 1/1 and 3.1% showed MIC >1 mg/L. 12 They concluded that a significant percentage of contemporary S. aureus isolates from Greek patients have a vancomycin MIC (>1mg/L) that may compromise the clinical efficacy of the drug for the treatment of serious infections. 12 An 84 samples (52%) in the present study grew no organism.…”

“…12 They concluded that a significant percentage of contemporary S. aureus isolates from Greek patients have a vancomycin MIC (>1mg/L) that may compromise the clinical efficacy of the drug for the treatment of serious infections. 12 An 84 samples (52%) in the present study grew no organism.…”