Till Örebro universitet

BACKGROUND: CoNS constitute a significant part of the human microbiota of skin and mucous membranes. They can cause nosocomial infections, and have shown decreased susceptibility to several antibiotics. The few remaining treatment options include (lipo)glycopeptides such as dalbavancin. However, there is a lack of knowledge concerning whether susceptibility to lipoglycopeptides varies between different species of CoNS.

OBJECTIVES: To determine the susceptibility to dalbavancin in different species of CoNS.

METHODS: We investigated 480 bacterial isolates from 10 CoNS species: Staphylococcus epidermidis, Staphylococcus capitis, Staphylococcus caprae, Staphylococcus haemolyticus, Staphylococcus lugdunensis, Staphylococcus warneri, Staphylococcus pettenkoferi, Staphylococcus hominis, Staphylococcus sciuri and Staphylococcus simulans. The isolates were randomly selected from different sources of infection, including blood isolates, as well as deep and superficial infections. Antibiotic susceptibility was tested with the gradient test method.

RESULTS: There was a statistically significant difference (ANOVA; P < 0.0001) in the MIC distribution for dalbavancin between different CoNS species. S. sciuri was the least susceptible species, with 90% of the isolates having an MIC value for dalbavancin above the EUCAST breakpoint of 0.125 mg/L. The lowest MIC90 values were seen for S. capitis, S. simulans and S. caprae (all 0.032 mg/L).

CONCLUSIONS: This study demonstrated a difference in dalbavancin susceptibility between different CoNS species, suggesting that species-specific breakpoints for CoNS should be further investigated.