In vivoemergence of ceftaroline resistance during therapy for MRSA vertebral osteomyelitis: Table 1.

Abstract

cluster was typed by MLST according to the Pasteur Institute scheme (www.pasteur.fr/mlst), giving rise to the subsequent clones ST326 (CX1), ST405 (CX2), ST147 (CX3), ST104 (CX4 and CX5) and ST15 (CX6) (Figure 1). Of note, all clones except ST104 had previously been associated with OXA-48 production in Europe and/or Spain. 1,8,9 The concomitant occurrence of five different K. pneumoniae clones producing OXA-48 in a single hospital might be explained, at least in part, by the high transfer frequency of the IncL/M plasmid carrying the bla OXA-48 gene. 10 In view of our data, it is likely that the spread of OXA-48-producing K. pneumoniae in Spain will rapidly mirror the endemic situation observed in Italy and the USA with KPC-producing K. pneumoniae isolates. Once again, this bacterial species is playing a pivotal role in the emergence and dispersion of resistance traits in hospital settings. Urgent hygiene measures have to be taken to prevent further consolidation of a difficult-to-control situation.

Evaluation of the Revised Ceftaroline Disk Diffusion Breakpoints When Testing a Challenge Collection of Methicillin-Resistant Staphylococcus aureus Isolates

“…Several examples presented here illustrate scenarios where wild-type MRSA isolates had ceftaroline MIC results of 2 to 4 μg/ml in the SDD category, while an isolate carrying an alteration at the PBD of PBP2a (K565N) had a reproducible ceftaroline MIC value of 1 μg/ml. Several PBP2a alterations detected here were reported previously and were associated with isolates having ceftaroline MIC results of ≥2 μg/ml ( 6 , 25 – 27 ). However, the relevance of PBP2a mutations, such as K565N (ceftaroline MIC of 1 μg/ml and zone diameters ranging from 22 to 28 mm), at the transpeptidase site remains unknown.…”

Use of Ceftaroline Fosamil in Children: Review of Current Knowledge and its Application

“…Mutant selection did not occur in Gram-positive bacteria evaluated in vitro, including S. aureus and S. pneumoniae after repeated exposure to ceftaroline [ 19 , 20 ]. However, clinical implication of the in vitro finding is not yet fully understood, and the emergence of resistance to ceftaroline during a course of therapy has been reported, even though extremely rare [ 21 , 22 ]. Currently, prevalence of ceftaroline-resistant organisms appears to be fairly rare in surveillance studies conducted in the United States, with 97.6% MRSA strains and 100% S. pneumoniae strains being susceptible to ceftaroline [ 23 , 24 ].…”

New Antibiotics for the Treatment of Acute Bacterial Skin and Soft Tissue Infections in Pediatrics

“…Moreover, it is active against vancomycin-intermediate S. aureus and some Gram-negative rods, excluding those producing extended-spectrum β-lactamases or carbapenemases [ 49 , 50 ]. Finally, the in vitro studies seem to indicate that bacteria exposed to CF have a low propensity to develop resistance [ 51 , 52 ], although the emergence of resistant strains during treatment has been described [ 53 , 54 ]. This antibiotic is licensed by the FDA for the treatment of community acquired pneumonia and aSSTIs in adults and children 2 months of age and older [ 55 ] and by the EMA [ 56 ] for adults and children of any age, including neonates.…”