Decreased Susceptibility to Teicoplanin and Vancomycin in Coagulase-Negative Staphylococci Isolated from Orthopedic-Device-Associated Infections

Abstract

We studied 315 coagulase-negative Staphylococcus strains recovered prospectively during 240 surgical procedures (206 subjects) from proven or suspected device-associated bone and joint infections. Sixteen strains (5.1%) had decreased susceptibility to glycopeptides: 15 (12 S. epidermidis strains, 2 S. capitis strains, and 1 S. haemolyticus strain) to teicoplanin alone (MIC of 16 mg/liter, n ‫؍‬ 9; MIC of 32 mg/liter, n ‫؍‬ 6) and one (S. epidermidis) to both teicoplanin and vancomycin (MIC, 16 and 8 mg/liter, respectively). Decreased susceptibility to teicoplanin was more prevalent in "infecting" strains (i.e., strains recovered from >2 distinct intraoperative samples) than in "contaminants"

Teicoplanin non-susceptible coagulase-negative staphylococci in a large Australian healthcare network: Implications for treatment with vancomycin

“…8,11,12 Other species which have been reported to be glycopeptide non-susceptible include S. lugdunensis, S. capitis and S. simulans. 2,4,6,13 However, none of these species were identified as Teico-NS in the current study. CoNS from patients in ICU were more likely to be Teico-NS.…”

“…8 Other studies have reported reduced susceptibility overall to glycopeptides at 5.1% and teicoplanin at 8.1%. 2 Similarly, our study showed 7.2% of isolates to be Teico-NS with vancomycin resistance at 0.3%.…”

“…2 Some CoNS are able to colonise polymer surfaces by the formation of a thick, adherent, multilayered biofilm which can interfere with host defense mechanisms such as opsonophagocytosis. 3 Over the past few decades, the significance of CoNS has increased due to the growing number of device implantations and immunocompromised patients.…”

“…4,5 CoNS have also become one of the most common causes of bacteraemia in immunosuppressed patients. 2 Treatment of CoNS infections can be challenging owing to the frequent presence of foreign materials and increasing antimicrobial resistance. Resistance to methicillin in CoNS is very common among isolates recovered from hospitalized individuals.…”

In vitro susceptibility of Staphylococcus aureus and Staphylococcus epidermidis isolated from prosthetic joint infections

“…7 Both MRSA and MRSE strains are also usually resistant to other antibiotics, and although vancomycin remains the elective therapy for these cases, its efficacy has been declining over the last few years. 8,9 For this reason, other antibiotics have recently been considered as alternatives to vancomycin. [10][11][12][13][14][15] Despite these facts, antimicrobial susceptibility remains extremely variable among these microorganisms, making it necessary to perform individual susceptibility studies for each strain to select the best antibiotic combination for treatment.…”