Association between daptomycin susceptibility and teicoplanin resistance in Staphylococcus epidermidis

Jun Maki,Koichiro Suemori,Mamoru Tanaka,Hiroshi Kimura,Shingo Takatori,Hitoshi Miyamoto,Akihiro Tanaka,Keiko Tanaka,Shinobu Murakami,Hisamichi Tauchi,Hiroaki Araki,Takumi Yamaguchi,Shinichi Watanabe,Yukinobu Kawakami

doi:10.1038/s41598-019-55149-z

Abstract

Staphylococcus epidermidis infections are a common occurrence in hospitals, particularly in catheter-related bloodstream and surgical site infections and infective endocarditis. Higher daptomycin minimum inhibitory concentration (MIC) values may be associated with daptomycin treatment failure among patients with S. epidermidis infections. We therefore conducted a retrospective cohort study to determine the predictive value of daptomycin susceptibility. A retrospective study was undertaken in 1,337 patients with S. epidermidis infections. Data were collected from 1 January 2013 to 31 December 2016 at Ehime University Hospital, and included the following clinicopathological factors for evaluation: age, sex, resistance to vancomycin or teicoplanin, and history of antimicrobial therapy. Multiple analysis was performed using logistic regression to identify factors that independently and significantly affected the daptomycin resistance. Daptomycin-resistant S. epidermidis was identified in 38 (2.8%) patients. According to the multiple analysis, only higher MIC values (≥16 mg/L) for teicoplanin (P < 0.0001) were independently associated with an increased risk of developing daptomycin resistance. In conclusion, higher teicoplanin MIC values may predict resistance to daptomycin treatment in S. epidermidis infections.

Highlights

Staphylococcus epidermidis infections are a common occurrence in hospitals, in catheterrelated bloodstream and surgical site infections and infective endocarditis
Our findings demonstrate that a lower susceptibility to teicoplanin was independently associated with an increased risk of lower susceptibility to daptomycin in patients with S. epidermidis infection
Teicoplanin is considered as effective as vancomycin for the treatment of MRSA bacteraemia[8]

Summary

Introduction

Staphylococcus epidermidis infections are a common occurrence in hospitals, in catheterrelated bloodstream and surgical site infections and infective endocarditis. Higher daptomycin minimum inhibitory concentration (MIC) values may be associated with daptomycin treatment failure among patients with S. epidermidis infections. According to the multiple analysis, only higher MIC values (≥16 mg/L) for teicoplanin (P < 0.0001) were independently associated with an increased risk of developing daptomycin resistance. Higher teicoplanin MIC values may predict resistance to daptomycin treatment in S. epidermidis infections. Daptomycin exhibits bactericidal activity by penetrating the bacterial cell wall and binding to the cytoplasmic membrane, thereby causing rapid depolarization of the membrane. This results in the loss of membrane potential and bacterial cell death[2]. A high minimum inhibitory concentration (MIC) of daptomycin may contribute to treatment failure in patients with S. epidermidis, especially methicillin-resistant S. epidermidis (MRSE), infections. We conducted a retrospective cohort study to determine the predictive value of daptomycin susceptibility

Methods

Results

Conclusion