Abstract
Baseline methicillin-resistant Staphylococcus aureus (MRSA) isolates from patients with nosocomial and community-acquired pneumonia collected during Phase 3 trials for ceftobiprole were characterized. Eighty-four unique isolates from patients enrolled in Europe (50.0%), Asia-Western Pacific region (APAC; 20.2%), North America (19.0%), Latin America (8.3%), and South Africa (2.4%) were included. Antimicrobial susceptibility testing was performed by broth microdilution and isolates screened for Panton-Valentine leukocidin. SCCmec and agr types were determined. Strains were subjected to pulsed-field gel electrophoresis and spa typing. Clonal complexes (CCs) were assigned based on spa and/or multilocus sequence typing. Most isolates were CC5-MRSA-I/II/IV (44.0%; 37/84), followed by CC8-MRSA-IV (22.6%; 19/84) and CC239-MRSA-III (21.4%; 18/84). Other MRSA formed seven clonal clusters. Isolates from North America were associated with USA100, while those from South America belonged to the Cordobes/Chilean CC. A greater clonal diversity was observed in Europe; however, each country had CC5, CC8, or CC239 as prevalent lineages. Isolates from APAC were CC5-MRSA-II (47.1%; 8/17) or CC239-MRSA-III (47.1%; 8/17). Isolates carrying SCCmec I and III had ceftobiprole MIC50 values of 2 μg/ml, while those isolates with SCCmec II and IV had MIC50 values of 1 μg/ml. Ceftobiprole inhibited 96% and 100.0% of the isolates at ≤2 and ≤4 μg/ml, respectively. These isolates represented common circulating MRSA clones. Ceftobiprole demonstrated in vitro activity with a slight variation of minimum inhibitory concentrations (MICs) according to SCCmec or clonal type.
Highlights
Staphylococcus aureus, including methicillin-resistant isolates (MRSA), remains a leading cause of human bacterial infections in the European Union (EU), USA, and other parts of the world.[15,18,19] methicillin-resistant Staphylococcus aureus (MRSA) infections account for 44% of hospital-acquired infections (HAI) among institutions of the EU member States, Iceland, and Norway.[19]
Baseline methicillin-resistant Staphylococcus aureus (MRSA) isolates from patients with nosocomial and community-acquired pneumonia collected during Phase 3 trials for ceftobiprole were characterized
MRSA infections account for 44% of hospital-acquired infections (HAI) among institutions of the EU member States, Iceland, and Norway.[19]
Summary
Staphylococcus aureus, including methicillin-resistant isolates (MRSA), remains a leading cause of human bacterial infections in the European Union (EU), USA, and other parts of the world.[15,18,19] MRSA infections account for 44% of hospital-acquired infections (HAI) among institutions of the EU member States, Iceland, and Norway.[19]. The usual high rates of MRSA infections and the attributable mortality and costs associated with these infections have prompted the development of new anti-gram-positive agents, including ceftobiprole.[19] Ceftobiprole is a novel and broad-spectrum cephalosporin for intravenous administration. This agent has demonstrated an anti-MRSA activity due to its high affinity for the S. aureus penicillin-binding protein 2a (PBP2a) as well as the normal complement of b-lactam-sensitive PBPs. Ceftobiprole has shown in vitro activity against the common bacterial pathogens causing pneumonia, including Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae, and noncarbapenemase expressing extended-spectrum b-lactamasenegative Klebsiella pneumoniae and Pseudomonas spp.[5,14,38]
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