Susceptibility of clinical isolates of meticillin-resistant Staphylococcus aureus and phenotypic non-extended-spectrum β-lactamase-producing Klebsiella pneumoniae to ceftaroline in Taiwan: Results from Antimicrobial Testing Leadership and Surveillance (ATLAS) in 2012–2018 and Surveillance of Multicentre Antimicrobial Resistance in Taiwan (SMART) in 2018–2019
Journal
International Journal of Antimicrobial Agents
Journal Volume
56
Journal Issue
1
Date Issued
2020
Author(s)
Abstract
Data on ceftaroline (CPT) susceptibility amongst clinical isolates of meticillin-resistant Staphylococcus aureus (MRSA, n=1284) and phenotypic non-extended-spectrum β-lactamase-producing (non-ESBL-P) Klebsiella pneumoniae (n=466), obtained from the Antimicrobial Testing Leadership and Surveillance (ATLAS) programme from 2012 to 2018, and selected MRSA isolates from patients with bloodstream infections (BSIs) (n=95) from the Surveillance of Multicentre Antimicrobial Resistance in Taiwan (SMART) programme from 2018 to 2019 were analysed. The minimum inhibitory concentrations (MICs) of ATLAS isolates were determined using the broth microdilution method, whereas the MICs of SMART BSI-MRSA isolates were determined using the Etest and MicroScan system. The pharmacokinetic profiles and pharmacodynamic parameters of CPT were applied to explore the optimal dosage against infections caused by Taiwanese MRSA and K. pneumoniae isolates. Approximately 7.1% of ATLAS MRSA isolates were susceptible-dose dependent (S-DD) to CPT, and 19.7% of the non-ESBL-P K. pneumoniae isolates were not susceptible to CPT. Amongst the ATLAS MRSA isolates, the S-DD rates to CPT amongst isolates causing lower respiratory tract infections were 11.9% and 8.5% for isolates from intensive care units (ICUs) and general wards (GWs), and those causing skin and soft tissue infections (SSTIs) were 20% and 5.3% for isolates from ICUs and GWs, respectively (P=0.015). Of the SSTI MRSA isolates from GWs, 22.7% displayed vancomycin MICs >1 mg/L. Amongst 95 SMART BSI MRSA isolates, 28 (46.7%) isolates exhibited lower CPT MICs by the Etest compared with 60 isolates with CPT MICs of 1–2 mg/L by the MicroScan system. CPT 600 mg as a 2-h intravenous infusion every 8 h is suggested for treatment of infections caused by MRSA and phenotypic non-ESBL-P K. pneumoniae in Taiwan. ? 2020 Elsevier Ltd
Subjects
Ceftaroline; Extended-spectrum β-lactamase; Klebsiella pneumoniae; Lower respiratory tract infection; Meticillin-resistant Staphylococcus aureus; Skin and soft tissue infection
SDGs
Other Subjects
ceftaroline; vancomycin; antiinfective agent; beta lactamase; ceftaroline; cephalosporin derivative; antibiotic sensitivity; Article; bacterium isolate; bloodstream infection; broth dilution; controlled study; epsilometer test; human; in vitro study; intensive care unit; Klebsiella pneumoniae; lower respiratory tract infection; methicillin resistant Staphylococcus aureus; MIC50; MIC90; non extended spectrum beta lactamase producing Klebsiella pneumoniae; priority journal; skin and soft tissue infection; skin and soft tissue infection; skin infection; soft tissue infection; Taiwan; Taiwanese; antibiotic resistance; bacterial skin disease; clinical trial; drug effect; genetics; isolation and purification; Klebsiella pneumoniae; metabolism; methicillin resistant Staphylococcus aureus; microbial sensitivity test; microbiology; multicenter study; respiratory tract infection; Anti-Bacterial Agents; beta-Lactamases; Cephalosporins; Drug Resistance, Bacterial; Humans; Klebsiella pneumoniae; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Respiratory Tract Infections; Skin Diseases, Bacterial; Soft Tissue Infections; Taiwan
Type
journal article