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Clinical efficacy of teicoplanin in the treatment of bloodstream infection caused by methicillin-resistant coagulase-negative staphylococci.
Yamada, Kumiko; Ueda, Takashi; Nakajima, Kazuhiko; Ichiki, Kaoru; Tsuchida, Toshie; Otani, Naruhito; Takahashi, Yoshiko; Ikeuchi, Hiroki; Uchino, Motoi; Koshiba, Masahiro; Takesue, Yoshio.
Afiliación
  • Yamada K; Department of Clinical Technology, Hyogo College of Medicine, Hyogo, Japan. Electronic address: yamakumi@hyo-med.ac.jp.
  • Ueda T; Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. Electronic address: taka76@hyo-med.ac.jp.
  • Nakajima K; Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. Electronic address: nakajima@hyo-med.ac.jp.
  • Ichiki K; Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. Electronic address: ichiki@hyo-med.ac.jp.
  • Tsuchida T; Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. Electronic address: tsuchida@huhs.ac.jp.
  • Otani N; Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. Electronic address: n-otani@hyo-med.ac.jp.
  • Takahashi Y; Department of Pharmacy, The Hospital of Hyogo College of Medicine, Hyogo, Japan. Electronic address: yktabu@hyo-med.ac.jp.
  • Ikeuchi H; Department of Inflammatory Bowel Disease, Hyogo College of Medicine, Hyogo, Japan. Electronic address: ikeuci2s@hyo-med.ac.jp.
  • Uchino M; Department of Inflammatory Bowel Disease, Hyogo College of Medicine, Hyogo, Japan. Electronic address: uchino2s@hyo-med.ac.jp.
  • Koshiba M; Department of Clinical Laboratory Medicine, Hyogo College of Medicine, Hyogo, Japan. Electronic address: mkoshiba@hyo-med.ac.jp.
  • Takesue Y; Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo, Japan. Electronic address: takesuey@hyo-med.ac.jp.
J Infect Chemother ; 26(5): 459-464, 2020 May.
Article en En | MEDLINE | ID: mdl-31870587
Empirical combination therapy with ß-lactams and glycopeptides is recommended for patients with presumed staphylococcal bloodstream infection (BSI). While coagulase-negative staphylococci (CNS) remain susceptible to vancomycin, such isolates have become less susceptible to teicoplanin. The aim of this retrospective study was to evaluate the clinical efficacy of teicoplanin in the treatment of BSI caused by methicillin-resistant CNS according to teicoplanin susceptibility. Inclusion criteria were patients with intravascular-catheter related BSIs caused by methicillin-resistant CNS (positive for two or more specimens); teicoplanin therapy; and at least one of the signs or symptoms caused by BSI. Antimicrobial resistance was defined as minimum inhibitory concentration (MIC) ≥8 µg/mL. The primary efficacy endpoint was clinical success evaluated 2 weeks after the completion of teicoplanin therapy [test of cure (TOC)]. Resistant rate of CNS was 0% for vancomycin and 22.9% for teicoplanin, and geometric mean MICs were 1.31 µg/mL and 3.41 µg/mL, respectively (p < 0.001). The catheter was removed in all patients except one, and high early clinical response at 72 h after starting therapy was obtained irrespective of teicoplanin susceptibility. The clinical success rate at TOC was 60% in patients with BSIs caused by teicoplanin-resistant strains, while 90% in patients with BSIs caused by susceptible strains (p = 0.052). In multivariate analyses, teicoplanin resistance was significant factor for decreased clinical success at TOC (adjusted odds ratio 0.138, 95% confidence interval 0.020-0.961, p = 0.045). Because of the poor clinical efficacy of teicoplanin against teicoplanin-resistant CNS, combination therapy comprising vancomycin and ß-lactam antibiotics should be considered in presumed staphylococci BSI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Staphylococcus / Resistencia a la Meticilina / Bacteriemia / Teicoplanina Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Infect Chemother Asunto de la revista: MICROBIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2020 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Staphylococcus / Resistencia a la Meticilina / Bacteriemia / Teicoplanina Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Infect Chemother Asunto de la revista: MICROBIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2020 Tipo del documento: Article Pais de publicación: Países Bajos