Prevalence and Characterization of the Cefazolin Inoculum Effect in North American Methicillin-Susceptible Staphylococcus aureus Isolates

Fecha de publicación: 01/01/2022 Fecha Ahead of Print: 01/05/2022

Autores organización

Jinnethe Cristina Reyes Manrique

Autor

Autores

Dingle T.C.
Gamage D.
Gomez-Villegas S.
Hanson B.M.
Abbott A.
Burnham C.-A.D.
Bard J.D.
Fritz S.
Miller W.R.
Westblade L.F.
Zimmer B.
Arias C.A.
Butler-Wu S.

Grupos de investigación

Unidad de Genética y Resistencia Antimicrobiana UGRA

Resumen

Antistaphylococcal penicillins and cefazolin remain the primary treatments for infections with methicillin-susceptible Staphylococcus aureus (MSSA). The cefazolin inoculum effect (CzIE) causes the cefazolin MIC to be elevated in proportion to the number of bacteria in the inoculum. The objective of this multicenter study was to evaluate the prevalence of the CzIE in North American MSSA isolates. Clinical MSSA isolates from six microbiology laboratories in the United States and one microbiology laboratory in Canada were screened for the CzIE by broth microdilution at a standard inoculum (;5 × 105 CFU/mL) and a high inoculum (;5 × 107 CFU/mL). Genome sequencing was performed to further characterize the MSSA isolates. The CzIE was present in 57/305 (18.6%) MSSA isolates, ranging from 0% to 27.9% across study sites. More of the CzIE-positive isolates (29.8%) had standard inoculum cefazolin MICs of 1.0 mg/mL than the CzIE-negative isolates did (3.2%) (P, 0.0001). Conversely, more CzIE-negative isolates (39.5%) had standard inoculum MICs of 0.25 mg/mL than the CzIE positive isolates did (5.3%) (P, 0.0001). The most common BlaZ b-lactamase types found in the CzIE-positive strains were type C (53.7%) and type A (44.4%). ST8 and ST30 were the most common sequence types among CzIE-positive isolates and correlated with BlaZ type C and A, respectively. The CzIE was present in up to a quarter of clinical MSSA isolates from North American clinical laboratories. Further studies to determine the impact of the presence of the CzIE on clinical outcomes are needed. © 2022 American Societ for Microbiology. All Rights Reserved.

Datos de la publicación

ISSN/ISSNe:: 0095-1137, 1098-660X
Tipo:: Article
Páginas:: -
DOI:: 10.1128/jcm.02495-21
Enlace a otro recurso:: www.scopus.com

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Métricas

Filiaciones

Dingle T.C.:: Alberta Precision Laboratories, Public Health Laboratory, Calgary, AB, Canada

Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
Gamage D.:: Accelerate Diagnostics, Inc., Tucson, AZ, United States
Gomez-Villegas S.:: Division of Infectious Diseases, Houston Methodist Hospital, Houston, TX, United States

Center for Infectious Disease Research, Houston Methodist Research Institute, Houston, TX, United States
Hanson B.M.:: Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
Reyes J.:: Universidad. Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia
Abbott A.:: Deaconess Health System, Evansville, IN, United States
Burnham C.-A.D.:: Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States

Department of Molecular Microbiology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States

Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, United States

Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
Bard J.D.:: Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, United States

Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
Fritz S.:: Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
Miller W.R.:: Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, United States

Division of Infectious Diseases, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, United States
Westblade L.F.:: Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, United States
Zimmer B.:: Beckman Coulter, Inc., Brea, CA, United States
Arias C.A.:: Division of Infectious Diseases, Houston Methodist Hospital, Houston, TX, United States

Center for Infectious Disease Research, Houston Methodist Research Institute, Houston, TX, United States
Butler-Wu S.:: Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

Keywords

Anti-Bacterial Agents; Bacteremia; Cefazolin; Humans; Methicillin; North America; Prevalence; Staphylococcal Infections; Staphylococcus aureus; cefazolin; antiinfective agent; cefazolin; meticillin; antibiotic resistance; antibiotic sensitivity; Article; bacterial endocarditis; bacterial strain; bacterial virulence; bacterium identification; bacterium isolation; broth dilution; clinical outcome; colony forming unit; controlled study; disease severity; disk diffusion; gene mutation; gene sequence; human; inoculation; Klebsiella pneumoniae; methicillin susceptible Staphylococcus aureus; microbiology; minimum inhibitory concentration; multicenter study; multilocus sequence typing; nonhuman; osteomyelitis; outcome assessment; phenotype; phylogeny; prevalence; quality control; Staphylococcus aureus; bacteremia; clinical trial; genetics; North America; Staphylococcus infection