A Multicenter Study To Evaluate Ceftaroline Breakpoints: Performance in an Area with High Prevalence of Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Lineage

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dc.contributor.authorKhan, Ayesha
dc.contributor.authorRivas, Lina
dc.contributor.authorSpencer, María
dc.contributor.authorMartínez, Rodrigo
dc.contributor.authorlam, Marusella
dc.contributor.authorRojas, Pamela
dc.contributor.authorPorte, Lorena
dc.contributor.authorSilva, Francisco
dc.contributor.authorBraun, Estefanía
dc.contributor.authorValdivieso, Francisca
dc.contributor.authorLhauser, Margareta
dc.contributor.authorLafourcade, Mónica
dc.contributor.authorMiller, Guillermo
dc.contributor.authorGarcía, Patricia
dc.contributor.authorArias, César
dc.contributor.authorMunita, José
dc.date.accessioned2022-03-25T19:45:41Z
dc.date.available2022-03-25T19:45:41Z
dc.date.issued2019
dc.description.abstractCeftaroline (CPT) is a broad-spectrum agent with potent activity against methicillin-resistant Staphylococcus aureus (MRSA). The sequence type 5 (ST5) Chilean-Cordobés clone, associated with CPT nonsusceptibility, is dominant in Chile, a region with high rates of MRSA infections. Here, we assessed the in vitro activity of CPT against a collection of MRSA isolates collected between 1999 and 2018 from nine hospitals (n = 320) and community settings (n = 41) in Santiago, Chile, and evaluated performance across testing methodologies. We found that our hospital-associated isolates exhibited higher CPT MIC distributions (MIC50 and MIC90 of 2 mg/liter) than the community isolates (MIC50 and MIC90 of 0.5 mg/liter), a finding that was consistent across time and independent of the culture source. High proportions (64%) of isolates were CPT nonsusceptible despite the absence of CPT use in Chile. Across methodologies, the Etest underestimated the MIC relative to the gold standard broth microdilution (BMD) test (MIC50 and MIC90 of 1 and 1.5 mg/liter, respectively). There was low (∼51%) categorical agreement (CA) between Etest and BMD results across CLSI and EUCAST breakpoints. The recent revision of CLSI guidelines abolished "very major error" (VME) from the previous guidelines (81%), which perform similarly to the EUCAST guidelines. The level of concordance between CLSI and EUCAST for BMD testing and Etest was >95%. Disk diffusion performed poorly relative to BMD under CLSI (CA, 55%) and EUCAST (CA, 36%) guidelines. Comparison of EUCAST to CLSI for disk diffusion (with EUCAST used as the reference) showed low agreement (CA, 25%; VME, 70%). In summary, CPT-nonsusceptible MRSA are dominant in clinical settings in Chile. Our results provide data to support the reevaluation of CPT breakpoints and to improve agreement across methodologies and agencies.es
dc.description.versionVersión publicadaes
dc.identifier.citationKhan A, Rivas LM, Spencer M, Martinez R, Lam M, Rojas P, Porte L, Silva F, Braun S, Valdivieso F, Mv Lhauser M, Lafourcade M, Miller WR, García P, Arias CA, Munita JM. A Multicenter Study To Evaluate Ceftaroline Breakpoints: Performance in an Area with High Prevalence of Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Lineage. J Clin Microbiol. 2019 Aug 26;57(9):e00798-19. doi: 10.1128/JCM.00798-19es
dc.identifier.urihttps://doi.org/10.1128/JCM.00798-19es
dc.identifier.urihttp://hdl.handle.net/11447/5808
dc.language.isoenes
dc.subjectEtestes
dc.subjectMICes
dc.subjectMRSAes
dc.subjectbreakpointses
dc.subjectCeftarolinees
dc.subjectDisk diffusiones
dc.titleA Multicenter Study To Evaluate Ceftaroline Breakpoints: Performance in an Area with High Prevalence of Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Lineagees
dc.typeArticlees
dcterms.sourceJournal of clinical microbiologyes

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