Trends in antibiotic resistance in coagulase-negative staphylococci in the United States, 1999 to 2012

Larissa S May, Eili Y. Klein, Richard E. Rothman, Ramanan Laxminarayan

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Coagulase-negative staphylococci (CoNS) are important bloodstream pathogens that are typically resistant to multiple antibiotics. Despite the concern about increasing resistance, there have been no recent studies describing the national prevalence of CoNS pathogens. We used national resistance data over a period of 13 years (1999 to 2012) from The Surveillance Network (TSN) to determine the prevalence of and assess the trends in resistance for Staphylococcus epidermidis, the most common CoNS pathogen, and all other CoNS pathogens. Over the course of the study period, S. epidermidis resistance to ciprofloxacin and clindamycin increased steadily from 58.3% to 68.4% and from 43.4% to 48.5%, respectively. Resistance to levofloxacin increased rapidly from 57.1% in 1999 to a high of 78.6% in 2005, followed by a decrease to 68.1% in 2012. Multidrug resistance for CoNS followed a similar pattern, and this rise and small decline in resistance were found to be strongly correlated with levofloxacin prescribing patterns. The resistance patterns were similar for the aggregate of CoNS pathogens. The results from our study demonstrate that the antibiotic resistance in CoNS pathogens has increased significantly over the past 13 years. These results are important, as CoNS can serve as sentinels for monitoring resistance, and they play a role as reservoirs of resistance genes that can be transmitted to other pathogens. The link between the levofloxacin prescription rate and resistance levels suggests a critical role for reducing the inappropriate use of fluoroquinolones and other broad-spectrum antibiotics in health care settings and in the community to help curb the reservoir of resistance in these colonizing pathogens.

Original languageEnglish (US)
Pages (from-to)1404-1409
Number of pages6
JournalAntimicrobial Agents and Chemotherapy
Volume58
Issue number3
DOIs
StatePublished - Mar 2014
Externally publishedYes

Fingerprint

Coagulase
Microbial Drug Resistance
Staphylococcus
Levofloxacin
Staphylococcus epidermidis
Anti-Bacterial Agents
Clindamycin
Fluoroquinolones
Multiple Drug Resistance
Ciprofloxacin
Prescriptions
Delivery of Health Care
Genes

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Infectious Diseases

Cite this

Trends in antibiotic resistance in coagulase-negative staphylococci in the United States, 1999 to 2012. / May, Larissa S; Klein, Eili Y.; Rothman, Richard E.; Laxminarayan, Ramanan.

In: Antimicrobial Agents and Chemotherapy, Vol. 58, No. 3, 03.2014, p. 1404-1409.

Research output: Contribution to journalArticle

May, Larissa S ; Klein, Eili Y. ; Rothman, Richard E. ; Laxminarayan, Ramanan. / Trends in antibiotic resistance in coagulase-negative staphylococci in the United States, 1999 to 2012. In: Antimicrobial Agents and Chemotherapy. 2014 ; Vol. 58, No. 3. pp. 1404-1409.
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abstract = "Coagulase-negative staphylococci (CoNS) are important bloodstream pathogens that are typically resistant to multiple antibiotics. Despite the concern about increasing resistance, there have been no recent studies describing the national prevalence of CoNS pathogens. We used national resistance data over a period of 13 years (1999 to 2012) from The Surveillance Network (TSN) to determine the prevalence of and assess the trends in resistance for Staphylococcus epidermidis, the most common CoNS pathogen, and all other CoNS pathogens. Over the course of the study period, S. epidermidis resistance to ciprofloxacin and clindamycin increased steadily from 58.3{\%} to 68.4{\%} and from 43.4{\%} to 48.5{\%}, respectively. Resistance to levofloxacin increased rapidly from 57.1{\%} in 1999 to a high of 78.6{\%} in 2005, followed by a decrease to 68.1{\%} in 2012. Multidrug resistance for CoNS followed a similar pattern, and this rise and small decline in resistance were found to be strongly correlated with levofloxacin prescribing patterns. The resistance patterns were similar for the aggregate of CoNS pathogens. The results from our study demonstrate that the antibiotic resistance in CoNS pathogens has increased significantly over the past 13 years. These results are important, as CoNS can serve as sentinels for monitoring resistance, and they play a role as reservoirs of resistance genes that can be transmitted to other pathogens. The link between the levofloxacin prescription rate and resistance levels suggests a critical role for reducing the inappropriate use of fluoroquinolones and other broad-spectrum antibiotics in health care settings and in the community to help curb the reservoir of resistance in these colonizing pathogens.",
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