Prevalence and molecular epidemiology of ceftaroline non-susceptible methicillin-resistant Staphylococcus aureus isolates, first clinical report from Iran

Acta Microbiol Immunol Hung. 2020 Dec 1;67(4):228-233. doi: 10.1556/030.2020.01273.

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens in Iran with a high prevalence and a high level of antibiotic resistance. Ceftaroline is a fifth generation cephalosporin binding and inhibiting penicillin binding protein (PBP2a).

Methods: In the present study, 228 clinical MRSA isolates were collected from four cities of Iran and their susceptibility to ceftaroline was evaluated by E-test and the disk diffusion method.

Results: Our results showed a high susceptibility rate (97.3%) to ceftaroline in MRSA strains from Iran. Six isolates were found to be ceftaroline non-susceptible (CPT-NS) with Minimum inhibitory concentration (MIC) ≥2 µg/mL. All CPT-NS isolates were isolated from blood and tracheal aspirate and belonged to SCCmec type III as well as agr type I and were all susceptible to vancomycin. Out of six isolates, three, two and one belonged to spa type t030, t4864, and t969, respectively. Vancomycin, quinupristin/dalfopristin, linezolid, chloramphenicol, and tigecycline were the most active agents against CPT-NS isolates.

Conclusion: Due to the broad-spectrum activity and low toxicity of ceftaroline as well as the increased rate of vancomycin resistance among MRSA strains in recent years, ceftaroline can be considered as a novel approach to treat MRSA-induced infections.

Keywords: Fifth-generation cephalosporin; Iran; MRSA; Staphylococcus aureus; ceftaroline.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Ceftaroline
  • Cephalosporins / pharmacology*
  • DNA, Bacterial / genetics
  • Humans
  • Iran / epidemiology
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / genetics*
  • Microbial Sensitivity Tests
  • Prevalence
  • Staphylococcal Infections / epidemiology*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • DNA, Bacterial