A multicenter study to evaluate ceftaroline breakpoints: Performance in an area with high prevalence of methicillin- resistant Staphylococcus aureus sequence type 5 lineage

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dc.contributor.authorKhan, Ayesha
dc.contributor.authorRivas, Lina M.
dc.contributor.authorSpencer, Maria
dc.contributor.authorMartinez, Rodrigo
dc.contributor.authorLam, Marusella
dc.contributor.authorRojas, Pamela
dc.contributor.authorPorte, Lorena
dc.contributor.authorSilva, Francisco
dc.contributor.authorBraun, Stephanie
dc.contributor.authorValdivieso, Francisca
dc.contributor.authorMvlhauser, Margareta
dc.contributor.authorLafourcade, Mónica
dc.contributor.authorMiller, William
dc.contributor.authorGarcía, Patricia
dc.contributor.authorArias, Cesar
dc.contributor.authorMunita, José M.
dc.date.accessioned2020-03-09T14:24:49Z
dc.date.available2020-03-09T14:24:49Z
dc.date.issued2019
dc.description.abstractenglishABSTRACT Ceftaroline (CPT) is a broad-spectrum agent with potent activity against methicillin-resistant Staphylococcus aureus (MRSA). The sequence type 5 (ST5) Chilean-Cordobés clone, associated with CPT nonsusceptibility, is dominant in Chile, a region with high rates of MRSA infections. Here, we assessed the in vitro activity of CPT against a collection of MRSA isolates collected between 1999 and 2018 from nine hospitals (n 320) and community settings (n 41) in Santiago, Chile, and evaluated performance across testing methodologies. We found that our hospitalassociated isolates exhibited higher CPT MIC distributions (MIC50 and MIC90 of 2 mg/liter) than the community isolates (MIC50 and MIC90 of 0.5 mg/liter), a finding that was consistent across time and independent of the culture source. High proportions (64%) of isolates were CPT nonsusceptible despite the absence of CPT use in Chile. Across methodologies, the Etest underestimated the MIC relative to the gold standard broth microdilution (BMD) test (MIC50 and MIC90 of 1 and 1.5 mg/liter, respectively). There was low (51%) categorical agreement (CA) between Etest and BMD results across CLSI and EUCAST breakpoints. The recent revision of CLSI guidelines abolished “very major error” (VME) from the previous guidelines (81%), which perform similarly to the EUCAST guidelines. The level of concordance between CLSI and EUCAST for BMD testing and Etest was 95%. Disk diffusion performed poorly relative to BMD under CLSI (CA, 55%) and EUCAST (CA, 36%) guidelines. Comparison of EUCAST to CLSI for disk diffusion (with EUCAST used as the reference) showed low agreement (CA, 25%; VME, 70%). In summary, CPT-nonsusceptible MRSA are dominant in clinical settings in Chile. Our results provide data to support the reevaluation of CPT breakpoints and to improve agreement across methodologies and agencies.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1128/JCM.00798-19
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn0095-1137
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2020
dc.language.isoeng
dc.publisherAmerican Society for Microbiologyspa
dc.publisher.journalJourna of Clinical Microbiologyspa
dc.relation.ispartofseriesJourna of Clinical Microbiology, 0095-1137, Vol. 57, Nro. 9, 2019, p.1-11spa
dc.relation.urihttps://jcm.asm.org/content/57/9/e00798-19
dc.rightsAttribution 4.0 International*
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf183
dc.rights.creativecommons2019
dc.rights.localAcceso abiertospa
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subject.decsStaphylococcus aureus resistente a meticilinaspa
dc.subject.decsBacilos grampositivos formadores de endosporasspa
dc.subject.decsPruebas Antimicrobianas de difusión por discospa
dc.subject.keywordsCeftarolinespa
dc.subject.keywordsDisk diffusionspa
dc.subject.keywordsEtestspa
dc.subject.keywordsBreakpointsspa
dc.titleA multicenter study to evaluate ceftaroline breakpoints: Performance in an area with high prevalence of methicillin- resistant Staphylococcus aureus sequence type 5 lineagespa
dc.title.translatedA multicenter study to evaluate ceftaroline breakpoints: Performance in an area with high prevalence of methicillin- resistant Staphylococcus aureus sequence type 5 lineage
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

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