Pathogens of skin and skin-structure infections in the UK and their susceptibility to antibiotics, including ceftaroline

Livermore, David ORCID:, Mushtaq, Shazad, Warner, Marina, James, Dorothy, Kearns, Angela M and Woodford, Neil (2015) Pathogens of skin and skin-structure infections in the UK and their susceptibility to antibiotics, including ceftaroline. Journal of Antimicrobial Chemotherapy, 70 (10). pp. 2844-2853. ISSN 0305-7453

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Objectives: Bacterial skin and skin-structure infections (SSSIs) are frequent settings for antibiotic use. We surveyed their UK aetiology and pathogen susceptibility, including susceptibility to ceftaroline. Methods: Consecutive SSSI isolates were collected at 35 UK hospitals, to a maximum of 60/site, together with 15 ‘supplementary’ MRSA/site. Isolates were re-identified and BSAC susceptibility testing was performed, with parallel CLSI agar testing for ceftaroline. Results: Isolates (n¼1908) were collected from 1756 hospitalized patients, predominantly with surgical and traumatic infections, abscesses and infected ulcers and largely from general medicine and general surgery patients. They included 1271 Staphylococcus aureus (201 MRSA), 162 b-haemolytic streptococci, 269 Enterobacteriaceae, 138 Pseudomonas aeruginosa and 37 enterococci. Most (944/1756) patients had monomicrobial MSSA infections. Rates of resistance to quinolones, gentamicin and cephalosporins were ,20% in Enterobacteriaceae and ,10% in P. aeruginosa. MRSA rates varied greatly among hospitals and were 2.5-fold higher in general medicine than in general surgery patients. At breakpoint, ceftaroline inhibited: (i) all MSSA and 97.6% of MRSA, with MICs of 2 mg/L for the few resistant MRSA; (ii) all b-haemolytic streptococci; and (iii) 83% of Enterobacteriaceae. High-level ceftaroline resistance in Enterobacteriaceae involved ESBLs or AmpCenzymes. Ceftaroline MICs by CLSI methodology generally equalled those by BSAC or were 2-fold higher, but this differential was 4–16-fold for P. aeruginosa. Conclusions: Irrespective of patient group, SSSIs were dominated by S. aureus. Most pathogens were susceptible, but 15.8% of S. aureus were MRSA, with locally higher prevalence.

Item Type: Article
Additional Information: J. Antimicrob. Chemother. (2015) doi: 10.1093/jac/dkv179
Uncontrolled Keywords: mrsa,staphylococcus aureus,ceftaroline,skin infection,susceptibility testing
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Depositing User: Pure Connector
Date Deposited: 23 Oct 2015 10:00
Last Modified: 21 Oct 2022 02:32
DOI: 10.1093/jac/dkv179


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