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Glycopeptide resistance in coagulase-negative staphylococci isolated in blood cultures from patients with hematological malignancies during three decades
Örebro University, School of Health and Medical Sciences.
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2011 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 30, no 11, p. 1349-1354Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to determine if there was a long-term increase in glycopeptide minimum inhibitory concentration (MIC) values, MIC creep, among bloodstream isolates of Staphylococcus epidermidis and S. haemolyticus isolated from patients with hematological malignancies. We conducted a retrospective single-center study where all positive blood cultures of S. epidermidis (n = 387) and S. haemolyticus (n = 19) isolated from patients with hematological malignancies during three decades, 1980 to 2009, were re-evaluated for the presence of reduced susceptibility to vancomycin and teicoplanin. Three different methods for the detection of reduced susceptibility to glycopeptides were used; standard Etest, macromethod Etest, and glycopeptide resistance detection (GRD) Etest. The median MIC value for vancomycin was 2 mg/L. MIC values for vancomycin and teicoplanin did not show any statistically significant increase during the study period. The presence of heterogeneously glycopeptide-intermediate staphylococci (hGIS) was analyzed among 405 coagulase-negative staphylococci (CoNS) isolates. hGIS were found in 31-45% of the CoNS isolates by the macromethod Etest and in 53-67% by the GRD Etest during the three decades. In conclusion, we did not observe any long-term glycopeptide MIC creep determined by the standard Etest, although a high and increasing proportion of heterogeneous vancomycin resistance was observed.

Place, publisher, year, edition, pages
2011. Vol. 30, no 11, p. 1349-1354
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-20840DOI: 10.1007/s10096-011-1228-8ISI: 000295864800006OAI: oai:DiVA.org:oru-20840DiVA, id: diva2:475838
Available from: 2012-01-11 Created: 2012-01-11 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Coagulase-negative staphylococci in hematological malignancy
Open this publication in new window or tab >>Coagulase-negative staphylococci in hematological malignancy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Bacterial infections are common in hematological malignancy. Coagulase-negative staphylococci (CoNS) are among the most prevalent causes of bacteremia in patients with hematological malignancies.

In this thesis, different aspects of CoNS in hematological malignancy have been studied in four papers:

In paper 1, CoNS blood culture isolates from patients with hematological malignancies treated at the University Hospital of Örebro from 1980 to 2009 were revaluated for the presence of reduced sensitivity to glycopeptides. A high incidence of heterogeneous-intermediate glycopeptide resistance was observed and there was a trend towards increasing incidence of this phenotype over time.

In paper 2, the colonization pattern of CoNS among patients undergoing intensive chemotherapy for hematological malignancy was investigated. A successive homogenization and an accumulation of CoNS phenotypes mutually present in a majority of included patients were demonstrated.

In paper 3, a PCR method to determine the clinical significance of positive blood cultures of the CoNS species Staphylococcus epidermidis was evaluated. The test failed to discriminate bloodstream infection from blood culture contamination.

Finally, in paper 4, the long-term molecular epidemiology of S. epidermidis blood culture isolates from patients with hematological malignancies was studied with multilocus sequence typing. A predominance of sequence type 2 was demonstrated during the entire 30 year study period.

In conclusion, the results are consistent with that CoNS have established as important pathogens by its capacity to colonize the human skin, its ability to reside and spread in the hospital environment and its rapid adaptation to stressors such as antimicrobials.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 56
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 95
Keywords
coagulase-negative staphylococci, hematological malignancy, Staphylococcus epidermidis, healthcare-associated infection, antibiotic susceptibility, molecular epidemiology, bloddstream infection, bacteremia
National Category
Hematology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-30750 (URN)978-91-7668-970-7 (ISBN)
Public defence
2013-10-15, Wilandersalen, Universitetssjukhuset i Örebro, S. Grev Roseng. 18, 703 62 ÖREBRO, 09:00 (Swedish)
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Available from: 2013-09-09 Created: 2013-09-09 Last updated: 2017-10-17Bibliographically approved

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Ahlstrand, ErikTidefelt, UlfSöderquist, Bo

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