Comparative activity of ceftobiprole against coagulase-negative staphylococci from the BSAC Bacteraemia Surveillance Programme, 2013–2015

Abstract

Coagulase-negative staphylococci (CoNS) are a significant cause of bacteraemia, the treatment of which is becoming increasingly complex due to the emergence of multidrug-resistant strains. This study aimed to evaluate the in vitro activity of ceftobiprole, an advanced-generation cephalosporin, as compared with other antimicrobial agents against CoNS from patients with bacteraemia. As part of the British Society for Antimicrobial Chemotherapy (BSAC) Bacteraemia Surveillance Programme, 650 blood isolates of CoNS were obtained from patients with bacteraemia at 74 centres throughout the UK and Ireland for the years 2013–2015. Minimum inhibitory concentrations (MICs) of ceftobiprole and other antimicrobial agents were determined using the BSAC agar dilution method. Susceptibility was assessed by European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. The majority of the isolates (63.2%) were Staphylococcus epidermidis. Overall, methicillin resistance, as determined by oxacillin susceptibility testing, was observed in 64.2% of isolates. The MIC50/90 of ceftobiprole was 1/2 mg/L, and 100% of CoNS isolates were inhibited at the EUCAST ceftobiprole non-species-specific pharmacokinetic/pharmacodynamic breakpoint of 4 mg/L. Only one isolate was resistant to vancomycin. Overall rates of resistance to ciprofloxacin, clindamycin, erythromycin and teicoplanin were 50.5, 25.1, 68.2 and 20.9%, respectively. In S. epidermidis, resistance to oxacillin was associated with increased resistance to other antimicrobials. Ceftobiprole demonstrated in vitro activity against all CoNS species isolated from patients with bacteraemia and was active against species resistant to other antistaphylococcal antimicrobials. The collection of clinical data regarding the efficacy of ceftobiprole in treating CoNS bacteraemia is warranted.

The species distribution, antimicrobial resistance and risk factors for poor outcome of coagulase-negative staphylococci bacteraemia in China

“…Multi-drug resistance has made vancomycin the first choice for anti-CoNS, and 25.5% (40/157) of patients were prescribed VAN for empirical antibiotic therapy within 72 h after the onset of CoNS bacteraemia in this study (Table 2). However, VAN-resistant CoNS does exist, for example, Anne Santerre Henriksen et al reported that 1 out of 460 isolates displayed resistance to VAN in their study [27]. For this reason, although VAN-resistant CoNS was not present in our study, we still inferred that VAN-resistant CoNS bacteraemia may appear, and it deserves our attention in the clinic.…”

Prevalence and antimicrobial resistance patterns of bacteria isolated from cerebrospinal fluid among children with bacterial meningitis in China from 2016 to 2018: a multicenter retrospective study

“…VAN remained the best option for the treatment of MRCoNS infections in patients with PBM. However, data from the UK and Ireland during 2013–2015 demonstrated that 0.2% of CoNS isolates were resistant to methicillin [ 26 ]. VAN-resistant CoNS exists in the clinic.…”

High Rate of Ceftobiprole Resistance among Clinical Methicillin-Resistant Staphylococcus aureus Isolates from a Hospital in Central Italy

“…Ceftobiprole, a fifth-generation broad-spectrum cephalosporin, shows activity against Gram-positive and Gram-negative bacteria and is also active against MRSA (3); in particular, it has demonstrated high affinity not only for the common PBPs but also for PBP2a (4). The antibiotic which has recently been approved has been shown to display relative stability against ␤-lactamases and a low propensity to develop resistance (3), as confirmed by the low rates of resistant staphylococcal isolates found in surveillance studies (5)(6)(7)(8). Nonetheless, some papers have described ceftobiprole resistance among MRSA strains (5,6,(9)(10)(11).…”