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Evaluation of telavancin susceptibility in isolates of Staphylococcus aureus with reduced susceptibility to vancomycin

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Historically, vancomycin has been considered a primary therapeutic option for treating infections with Staphylococcus aureus, but isolates with reduced vancomycin susceptibility (SA-RVS) (MIC ≥ 4 μg/mL) have emerged. Telavancin, a semisynthetic lipoglycopeptide, is an alternative treatment option for S. aureus, but data examining telavancin activity against SA-RVS are limited. In the present study, we characterize 300 isolates of S. aureus isolates (50 vancomycin-susceptible (VSSA) isolates and 250 SA-RVS isolates) from a large tertiary care, academic medical center, 51.8% of which were methicillin resistant (MRSA). Sixteen (6.4%) SA-RVS isolates were non-susceptible to telavancin, whereas all VSSA isolates were susceptible. Additionally, 3.6% of SA-RVS isolates were non-susceptible to daptomycin, with three (1.2%) isolates testing non-susceptible to both telavancin and daptomycin. When tested against other classes of antimicrobials, there were no statistical differences in susceptibility of VSSA and SA-RVS isolates, except for the fluoroquinolones (ciprofloxacin and moxifloxacin). Molecular characterization of the isolates showed that SCCmec types II and IV together represented over half of the SA-RVS isolates; 12.0% of the VSSA isolates were SCCmec type II. Using RepPCR, we detected 16 distinct strain types in this isolate collection, and tst-1 (gene encoding the Staphylococcus toxic shock syndrome super-antigen) carriage was low (5.4%). Overall, we show that in addition to reduced vancomycin susceptibility, a small, but clinically significant, proportion of SA-RVS isolates also demonstrate reduced susceptibility to both telavancin and daptomycin.

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Funding

Funding and supplies (Telavancin ETEST strip) for this study were provided by a grant from Theravance Biopharma US, Inc. awarded to C.A.B.

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  1. Allison R. McMullen

    Present address: Augusta University, Augusta, GA, USA

Authors and Affiliations

  1. Department of Pathology & Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA

    Allison R. McMullen, William Lainhart, Meghan A. Wallace, Angela Shupe & Carey-Ann D. Burnham

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  1. Allison R. McMullen
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  2. William Lainhart
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  3. Meghan A. Wallace
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  4. Angela Shupe
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Corresponding authors

Correspondence to Allison R. McMullen or Carey-Ann D. Burnham.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Washington University Human Research Protection Office, IRB ID # 201508039) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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McMullen, A.R., Lainhart, W., Wallace, M.A. et al. Evaluation of telavancin susceptibility in isolates of Staphylococcus aureus with reduced susceptibility to vancomycin. Eur J Clin Microbiol Infect Dis 38, 2323–2330 (2019). https://doi.org/10.1007/s10096-019-03683-z

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  • DOI: https://doi.org/10.1007/s10096-019-03683-z

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