Effect of Antibiotic Exposure on Staphylococcus epidermidis Responsible for Catheter-Related Bacteremia

Abstract

Coagulase-negative staphylococci (CoNS) and especially Staphylococcus epidermidis are responsible for health care infections, notably in the presence of foreign material (e.g., venous or central-line catheters). Catheter-related bacteremia (CRB) increases health care costs and mortality. The aim of our study was to evaluate the impact of 15 days of antibiotic exposure (ceftobiprole, daptomycin, linezolid and vancomycin) at sub-inhibitory concentration on the resistance, fitness and genome evolution of 36 clinical strains of S. epidermidis responsible for CRB. Resistance was evaluated by antibiogram, the ability to adapt metabolism by the Biofilm Ring test® and the in vivo nematode virulence model. The impact of antibiotic exposure was determined by whole-genome sequencing (WGS) and biofilm formation experiments. We observed that S. epidermidis strains presented a wide variety of virulence potential and biofilm formation. After antibiotic exposure, S. epidermidis strains adapted their fitness with an increase in biofilm formation. Antibiotic exposure also affected genes involved in resistance and was responsible for cross-resistance between vancomycin, daptomycin and ceftobiprole. Our data confirmed that antibiotic exposure modified bacterial pathogenicity and the emergence of resistant bacteria.

Characteristics, costs, and outcomes associated with central-line–associated bloodstream infection and hospital-onset bacteremia and fungemia in US hospitals

“…For example, we excluded CDC commensal microorganisms from the HOB definition to be consistent with a recently published paper; 8 however, commensals can be true pathogens depending on the number, proximity, and clinical interpretation of positive blood cultures. 21,22 Our data support and update prior reports on the burden of HOB in hospitalized patients. The ∼30% mortality rate of HOB in our study is generally comparable to HOB mortality rates reported in other US hospitals 23,24 and in Denmark, 25 and the mortality rate of 35.3% in patients with an ICU encounter is similar to the 36.6% reported in ICU admissions in France.…”

“…For example, we excluded CDC commensal microorganisms from the HOB definition to be consistent with a recently published paper; 8 however, commensals can be true pathogens depending on the number, proximity, and clinical interpretation of positive blood cultures. 21,22…”

In Vivo-Acquired Resistance to Daptomycin during Methicillin-Resistant Staphylococcus aureus Bacteremia

“…Whole Genome Sequencing (WGS) was carried out using Illumina MiSeq Sequencing system (Illumina, San Diego, CA, USA). Illumina library preparation was constructed using 250 ng of the extracted DNA following the Nextera XT DNA Prep Kit library paired-end protocol (paired-end read libraries, Illumina) and sequenced in a 39 h run providing 2 × 250 bp reads as previously described [38]. Quality control of the reads was performed directly on MiSeq output reads using FastQC software (v.0.11.7).…”

Antimicrobial Activity of 2-(Piperazin-1-yl)naphtho[2,3-d]thiazole-4,9-dione against Staphylococcus Strains

“…However, based on reports that have included species identification, one can assume that the vast majority of non-specified coagulase-negative staphylococci infections are due to S. epidermidis . In addition, S. epidermidis produces several factors used to colonise tissues or artificial surfaces, such as catheters [ 3 ]. Patients, especially those with an immunocompromised status, are susceptible to nosocomial infections through the use of devices and invasive procedures [ 4 ].…”