Glycopeptide resistance in coagulase-negative staphylococci isolated in blood cultures from patients with hematological malignancies during three decades

• Published in: European journal of clinical microbiology & infectious diseases Vol. 30; no. 11; pp. 1349 - 1354
• Main Authors: Ahlstrand, E., Svensson, K., Persson, L., Tidefelt, U., Söderquist, B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.11.2011; Springer; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - pharmacology; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacteremia - complications; Bacteremia - microbiology; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Blood; Blood culture; Catheters; Coagulase; Drug Resistance, Microbial; Glycopeptides; Glycopeptides - pharmacology; Hematologic Neoplasms - complications; Hematology; Hospitals; Humans; Immunocompromised Host; Infections; Infectious diseases; Internal Medicine; Laboratories; Malignancy; Medical Microbiology; Medical records; Medical sciences; Medicin; Medicine; Microbial Sensitivity Tests; Minimum inhibitory concentration; Pharmacology. Drug treatments; Retrospective Studies; Species Specificity; Staphylococcal Infections - complications; Staphylococcal Infections - microbiology; Staphylococcus epidermidis; Staphylococcus epidermidis - drug effects; Staphylococcus haemolyticus - drug effects; Statistical analysis; Sweden; Teicoplanin; Teicoplanin - pharmacology; Vancomycin; Vancomycin - pharmacology; Sweden; United States > US; Minimum Inhibitory Concentration; Vancomycin; Hematological Malignancy; Glycopeptide; Teicoplanin; Human; Peptides; Microbiology; Malignant hemopathy; Staphylococcus; Infection; Resistance; Microbiological investigation; Bacteria; Micrococcales; Micrococcaceae; Blood culture; Cancer
• ISSN: 0934-9723; 1435-4373; 1435-4373
• DOI: 10.1007/s10096-011-1228-8

The aim of this study was to determine if there was a long-term increase in glycopeptide minimum inhibitory concentration (MIC) values, MIC creep, among bloodstream isolates of Staphylococcus epidermidis and S. haemolyticus isolated from patients with hematological malignancies. We conducted a retrospective single-center study where all positive blood cultures of S. epidermidis ( n  = 387) and S. haemolyticus ( n  = 19) isolated from patients with hematological malignancies during three decades, 1980 to 2009, were re-evaluated for the presence of reduced susceptibility to vancomycin and teicoplanin. Three different methods for the detection of reduced susceptibility to glycopeptides were used; standard Etest, macromethod Etest, and glycopeptide resistance detection (GRD) Etest. The median MIC value for vancomycin was 2 mg/L. MIC values for vancomycin and teicoplanin did not show any statistically significant increase during the study period. The presence of heterogeneously glycopeptide-intermediate staphylococci (hGIS) was analyzed among 405 coagulase-negative staphylococci (CoNS) isolates. hGIS were found in 31–45% of the CoNS isolates by the macromethod Etest and in 53–67% by the GRD Etest during the three decades. In conclusion, we did not observe any long-term glycopeptide MIC creep determined by the standard Etest, although a high and increasing proportion of heterogeneous vancomycin resistance was observed.