Daptomycin and vancomycin non-susceptible methicillin-resistant Staphylococcus aureus clonal lineages from bloodstream infection in a Brazilian teaching hospital

Braz J Infect Dis. 2019 Mar-Apr;23(2):139-142. doi: 10.1016/j.bjid.2019.03.003. Epub 2019 Apr 24.

Abstract

Introduction: This study aimed to characterize Staphylococcus aureus isolates from bloodstream infections in patients attending a teaching hospital, between 2011 and 2015.

Methods: The minimum inhibitory concentration for daptomycin, linezolid, oxacillin, teicoplanin, vancomycin, and trimethoprim/sulfamethoxazole was accessed by broth microdilution. SCCmec type and clonal profile were determined by molecular tests. Vancomycin heteroresistance was evaluated using screening tests and by population analysis profile/area under the curve.

Results: Among 200 S. aureus isolates, 55 (27.5%) were MRSA, carrying SCCmec II (45.5%) or IV (54.5%). The most frequent MRSA lineages were USA100 (ST5-II) (45.5%) and USA800 (ST5-IV) (30.9%). Six isolates were confirmed as vancomycin heteroresistant, showing area under the curve ratio 1.1, 1.2 or 1.3 (four USA100, one USA800 and one USA1100 isolates).

Conclusions: Daptomycin and vancomycin non-susceptible MRSA clonal lineages were found in bloodstream infections over five years, highlighting the importance of continuous surveillance of multiresistant bacteria in hospitals.

Keywords: Bloodstream infection; Daptomycin; S. aureus; Vancomycin.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteremia / microbiology*
  • Brazil
  • Cross Infection / microbiology
  • Daptomycin / pharmacology*
  • Hospitals, Teaching
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests
  • Staphylococcal Infections / microbiology
  • Vancomycin / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Daptomycin