Trends in Antibiotic Resistance in Coagulase-Negative Staphylococci in the United States, 1999 to 2012

Abstract

dCoagulase-negative staphylococci (CoNS) are important bloodstream pathogens that are typically resistant to multiple antibiotics. Despite the concern about increasing resistance, there have been no recent studies describing the national prevalence of CoNS pathogens. We used national resistance data over a period of 13 years (1999 to 2012) from The Surveillance Network (TSN) to determine the prevalence of and assess the trends in resistance for Staphylococcus epidermidis, the most common CoNS pathogen, and all other CoNS pathogens. Over the course of the study period, S. epidermidis resistance to ciprofloxacin and clindamycin increased steadily from 58.3% to 68.4% and from 43.4% to 48.5%, respectively. Resistance to levofloxacin increased rapidly from 57.1% in 1999 to a high of 78.6% in 2005, followed by a decrease to 68.1% in 2012. Multidrug resistance for CoNS followed a similar pattern, and this rise and small decline in resistance were found to be strongly correlated with levofloxacin prescribing patterns. The resistance patterns were similar for the aggregate of CoNS pathogens. The results from our study demonstrate that the antibiotic resistance in CoNS pathogens has increased significantly over the past 13 years. These results are important, as CoNS can serve as sentinels for monitoring resistance, and they play a role as reservoirs of resistance genes that can be transmitted to other pathogens. The link between the levofloxacin prescription rate and resistance levels suggests a critical role for reducing the inappropriate use of fluoroquinolones and other broad-spectrum antibiotics in health care settings and in the community to help curb the reservoir of resistance in these colonizing pathogens.

Investigation of Glycopeptide Susceptibility of Coagulase-Negative Staphylococci (CoNS) From a Tertiary Care Hospital in Gorgan, Northern Iran

“…Among all CoNS species, S. haemolyticus, S. epidermidis, S. hominis, and S. warneri have more common shown resistance to vancomycin (23). However, in the current study, only one CoNS isolate, belonging to S. hominis, exhibited resistance to vancomycin using the disk diffusion test, which was revealed on PCR not to possess the vanA gene.…”

“…Antibiotic resistance has been a growing issue in the treatment of CoNS infections (23,27). The current study revealed that S. haemolyticus and S. epidermidis were the most prevalent CoNS from clinical isolates.…”

“…Antibiotic discs were purchased from Rosco Diagnostica (Denmark) and included ampi- (22,23). S. aureus, strain COL, was used as a control.…”

Epidemiology of antimicrobial resistance in bloodstream infections

“…37 Resistance rates up to 90% for methicillin, 78.6% for levofloxacin, 68% for ciprofloxacin, and 48.5% for clindamycin have been reported in US. 38 Multidrug resistancein CNS was found to be related with levofloxacin prescribing patterns. 38 Resistance to vancomycin is very rare, however a 20.8% resistance to teicoplanin was reported from UK, particulary in S. haemolyticus.…”

“…38 Multidrug resistancein CNS was found to be related with levofloxacin prescribing patterns. 38 Resistance to vancomycin is very rare, however a 20.8% resistance to teicoplanin was reported from UK, particulary in S. haemolyticus. 37 Although the reported rates are usually <1 .5%, linezolid resistance is emerging and might be a future concern in CNS.…”