The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia

Autores
Goss, William Miller; Seas, Carlos; Carvajal, Lina P.; Diaz, Lorena; Echeverri, Aura M.; Ferro, Carolina; Rios, Rafael; Porras, Paola; Luna, Carlos; Gotuzzo, Eduardo; Munita, Jose M.; Nannini, Esteban; Carcamo, Cesar; Reyes, Jinnethe; Arias, Cesar A.
Año de publicación
2018
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background. Recent studies have favored the use of cefazolin over nafcillin for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. The clinical influence of the cefazolin inoculum effect (CzIE) in the effectiveness of cephalosporins for severe MSSA infections has not been evaluated. Methods. We prospectively included patients from 3 Argentinian hospitals with S. aureus bacteremia. Cefazolin minimum inhibitory concentrations (MICs) were determined at standard (105 colony-forming units [CFU]/mL) and high (107 CFU/mL) inoculum. The CzIE was defined as an increase of MIC to ≥16 µg/mL when tested at high inoculum. Whole-genome sequencing was performed in all isolates. Results. A total of 77 patients, contributing 89 MSSA isolates, were included in the study; 42 patients (54.5%) had isolates with the CzIE. In univariate analysis, patients with MSSA exhibiting the CzIE had increased 30-day mortality (P = .034) and were more likely to have catheter-associated or unknown source of bacteremia (P = .033) compared with patients infected with MSSA isolates without the CzIE. No statistically significant difference between the groups was observed in age, clinical illness severity, place of acquisition (community vs hospital), or presence of endocarditis. The CzIE remained associated with increased 30-day mortality in multivariate analysis (risk ratio, 2.65; 95% confidence interval, 1.10-6.42; P = .03). MSSA genomes displayed a high degree of heterogeneity, and the CzIE was not associated with a specific lineage. Conclusions. In patients with MSSA bacteremia where cephalosporins are used as firstline therapy, the CzIE was associated with increased 30-day mortality. Clinicians should be cautious when using cefazolin as firstline therapy for these infections.
Fil: Goss, William Miller. University of Texas; Estados Unidos
Fil: Seas, Carlos. Universidad Peruana Cayetano Heredia; Perú
Fil: Carvajal, Lina P.. Universidad El Bosque; Colombia
Fil: Diaz, Lorena. Universidad El Bosque; Colombia. UTHealth McGovern Medical School; Estados Unidos
Fil: Echeverri, Aura M.. Universidad El Bosque; Colombia
Fil: Ferro, Carolina. Universidad El Bosque; Colombia
Fil: Rios, Rafael. Universidad El Bosque; Colombia
Fil: Porras, Paola. Universidad El Bosque; Colombia
Fil: Luna, Carlos. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Gotuzzo, Eduardo. Universidad Peruana Cayetano Heredia; Perú
Fil: Munita, Jose M.. Universidad del Desarrollo. Facultad de Medicina Clínica Alemana; Chile
Fil: Nannini, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Inmunología Clinica y Experimental de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Instituto de Inmunología Clinica y Experimental de Rosario; Argentina
Fil: Carcamo, Cesar. Universidad Peruana Cayetano Heredia; Perú
Fil: Reyes, Jinnethe. Universidad El Bosque; Colombia
Fil: Arias, Cesar A.. University of Texas; Estados Unidos
Materia
CEPHALOSPORINS
ENDOCARDITIS
INOCULUM EFFECT
METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/88583
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/88583
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremiaGoss, William MillerSeas, CarlosCarvajal, Lina P.Diaz, LorenaEcheverri, Aura M.Ferro, CarolinaRios, RafaelPorras, PaolaLuna, CarlosGotuzzo, EduardoMunita, Jose M.Nannini, EstebanCarcamo, CesarReyes, JinnetheArias, Cesar A.CEPHALOSPORINSENDOCARDITISINOCULUM EFFECTMETHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUShttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background. Recent studies have favored the use of cefazolin over nafcillin for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. The clinical influence of the cefazolin inoculum effect (CzIE) in the effectiveness of cephalosporins for severe MSSA infections has not been evaluated. Methods. We prospectively included patients from 3 Argentinian hospitals with S. aureus bacteremia. Cefazolin minimum inhibitory concentrations (MICs) were determined at standard (105 colony-forming units [CFU]/mL) and high (107 CFU/mL) inoculum. The CzIE was defined as an increase of MIC to ≥16 µg/mL when tested at high inoculum. Whole-genome sequencing was performed in all isolates. Results. A total of 77 patients, contributing 89 MSSA isolates, were included in the study; 42 patients (54.5%) had isolates with the CzIE. In univariate analysis, patients with MSSA exhibiting the CzIE had increased 30-day mortality (P = .034) and were more likely to have catheter-associated or unknown source of bacteremia (P = .033) compared with patients infected with MSSA isolates without the CzIE. No statistically significant difference between the groups was observed in age, clinical illness severity, place of acquisition (community vs hospital), or presence of endocarditis. The CzIE remained associated with increased 30-day mortality in multivariate analysis (risk ratio, 2.65; 95% confidence interval, 1.10-6.42; P = .03). MSSA genomes displayed a high degree of heterogeneity, and the CzIE was not associated with a specific lineage. Conclusions. In patients with MSSA bacteremia where cephalosporins are used as firstline therapy, the CzIE was associated with increased 30-day mortality. Clinicians should be cautious when using cefazolin as firstline therapy for these infections.Fil: Goss, William Miller. University of Texas; Estados UnidosFil: Seas, Carlos. Universidad Peruana Cayetano Heredia; PerúFil: Carvajal, Lina P.. Universidad El Bosque; ColombiaFil: Diaz, Lorena. Universidad El Bosque; Colombia. UTHealth McGovern Medical School; Estados UnidosFil: Echeverri, Aura M.. Universidad El Bosque; ColombiaFil: Ferro, Carolina. Universidad El Bosque; ColombiaFil: Rios, Rafael. Universidad El Bosque; ColombiaFil: Porras, Paola. Universidad El Bosque; ColombiaFil: Luna, Carlos. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Gotuzzo, Eduardo. Universidad Peruana Cayetano Heredia; PerúFil: Munita, Jose M.. Universidad del Desarrollo. Facultad de Medicina Clínica Alemana; ChileFil: Nannini, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Inmunología Clinica y Experimental de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Instituto de Inmunología Clinica y Experimental de Rosario; ArgentinaFil: Carcamo, Cesar. Universidad Peruana Cayetano Heredia; PerúFil: Reyes, Jinnethe. Universidad El Bosque; ColombiaFil: Arias, Cesar A.. University of Texas; Estados UnidosOxford University Press2018-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/88583Goss, William Miller; Seas, Carlos; Carvajal, Lina P.; Diaz, Lorena; Echeverri, Aura M.; et al.; The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia; Oxford University Press; Open Forum Infectious Diseases; 5; 6; 5-2018; 1-92328-89572328-8957CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1093/ofid/ofy123info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/ofid/article/5/6/ofy123/5003417info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-10T13:17:44Zoai:ri.conicet.gov.ar:11336/88583instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-10 13:17:44.527CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
title The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
spellingShingle The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
Goss, William Miller
CEPHALOSPORINS
ENDOCARDITIS
INOCULUM EFFECT
METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS
title_short The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
title_full The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
title_fullStr The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
title_full_unstemmed The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
title_sort The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia
dc.creator.none.fl_str_mv Goss, William Miller
Seas, Carlos
Carvajal, Lina P.
Diaz, Lorena
Echeverri, Aura M.
Ferro, Carolina
Rios, Rafael
Porras, Paola
Luna, Carlos
Gotuzzo, Eduardo
Munita, Jose M.
Nannini, Esteban
Carcamo, Cesar
Reyes, Jinnethe
Arias, Cesar A.
author Goss, William Miller
author_facet Goss, William Miller
Seas, Carlos
Carvajal, Lina P.
Diaz, Lorena
Echeverri, Aura M.
Ferro, Carolina
Rios, Rafael
Porras, Paola
Luna, Carlos
Gotuzzo, Eduardo
Munita, Jose M.
Nannini, Esteban
Carcamo, Cesar
Reyes, Jinnethe
Arias, Cesar A.
author_role author
author2 Seas, Carlos
Carvajal, Lina P.
Diaz, Lorena
Echeverri, Aura M.
Ferro, Carolina
Rios, Rafael
Porras, Paola
Luna, Carlos
Gotuzzo, Eduardo
Munita, Jose M.
Nannini, Esteban
Carcamo, Cesar
Reyes, Jinnethe
Arias, Cesar A.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CEPHALOSPORINS
ENDOCARDITIS
INOCULUM EFFECT
METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS
topic CEPHALOSPORINS
ENDOCARDITIS
INOCULUM EFFECT
METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background. Recent studies have favored the use of cefazolin over nafcillin for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. The clinical influence of the cefazolin inoculum effect (CzIE) in the effectiveness of cephalosporins for severe MSSA infections has not been evaluated. Methods. We prospectively included patients from 3 Argentinian hospitals with S. aureus bacteremia. Cefazolin minimum inhibitory concentrations (MICs) were determined at standard (105 colony-forming units [CFU]/mL) and high (107 CFU/mL) inoculum. The CzIE was defined as an increase of MIC to ≥16 µg/mL when tested at high inoculum. Whole-genome sequencing was performed in all isolates. Results. A total of 77 patients, contributing 89 MSSA isolates, were included in the study; 42 patients (54.5%) had isolates with the CzIE. In univariate analysis, patients with MSSA exhibiting the CzIE had increased 30-day mortality (P = .034) and were more likely to have catheter-associated or unknown source of bacteremia (P = .033) compared with patients infected with MSSA isolates without the CzIE. No statistically significant difference between the groups was observed in age, clinical illness severity, place of acquisition (community vs hospital), or presence of endocarditis. The CzIE remained associated with increased 30-day mortality in multivariate analysis (risk ratio, 2.65; 95% confidence interval, 1.10-6.42; P = .03). MSSA genomes displayed a high degree of heterogeneity, and the CzIE was not associated with a specific lineage. Conclusions. In patients with MSSA bacteremia where cephalosporins are used as firstline therapy, the CzIE was associated with increased 30-day mortality. Clinicians should be cautious when using cefazolin as firstline therapy for these infections.
Fil: Goss, William Miller. University of Texas; Estados Unidos
Fil: Seas, Carlos. Universidad Peruana Cayetano Heredia; Perú
Fil: Carvajal, Lina P.. Universidad El Bosque; Colombia
Fil: Diaz, Lorena. Universidad El Bosque; Colombia. UTHealth McGovern Medical School; Estados Unidos
Fil: Echeverri, Aura M.. Universidad El Bosque; Colombia
Fil: Ferro, Carolina. Universidad El Bosque; Colombia
Fil: Rios, Rafael. Universidad El Bosque; Colombia
Fil: Porras, Paola. Universidad El Bosque; Colombia
Fil: Luna, Carlos. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Gotuzzo, Eduardo. Universidad Peruana Cayetano Heredia; Perú
Fil: Munita, Jose M.. Universidad del Desarrollo. Facultad de Medicina Clínica Alemana; Chile
Fil: Nannini, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Inmunología Clinica y Experimental de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Instituto de Inmunología Clinica y Experimental de Rosario; Argentina
Fil: Carcamo, Cesar. Universidad Peruana Cayetano Heredia; Perú
Fil: Reyes, Jinnethe. Universidad El Bosque; Colombia
Fil: Arias, Cesar A.. University of Texas; Estados Unidos
description Background. Recent studies have favored the use of cefazolin over nafcillin for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. The clinical influence of the cefazolin inoculum effect (CzIE) in the effectiveness of cephalosporins for severe MSSA infections has not been evaluated. Methods. We prospectively included patients from 3 Argentinian hospitals with S. aureus bacteremia. Cefazolin minimum inhibitory concentrations (MICs) were determined at standard (105 colony-forming units [CFU]/mL) and high (107 CFU/mL) inoculum. The CzIE was defined as an increase of MIC to ≥16 µg/mL when tested at high inoculum. Whole-genome sequencing was performed in all isolates. Results. A total of 77 patients, contributing 89 MSSA isolates, were included in the study; 42 patients (54.5%) had isolates with the CzIE. In univariate analysis, patients with MSSA exhibiting the CzIE had increased 30-day mortality (P = .034) and were more likely to have catheter-associated or unknown source of bacteremia (P = .033) compared with patients infected with MSSA isolates without the CzIE. No statistically significant difference between the groups was observed in age, clinical illness severity, place of acquisition (community vs hospital), or presence of endocarditis. The CzIE remained associated with increased 30-day mortality in multivariate analysis (risk ratio, 2.65; 95% confidence interval, 1.10-6.42; P = .03). MSSA genomes displayed a high degree of heterogeneity, and the CzIE was not associated with a specific lineage. Conclusions. In patients with MSSA bacteremia where cephalosporins are used as firstline therapy, the CzIE was associated with increased 30-day mortality. Clinicians should be cautious when using cefazolin as firstline therapy for these infections.
publishDate 2018
dc.date.none.fl_str_mv 2018-05
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/88583
Goss, William Miller; Seas, Carlos; Carvajal, Lina P.; Diaz, Lorena; Echeverri, Aura M.; et al.; The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia; Oxford University Press; Open Forum Infectious Diseases; 5; 6; 5-2018; 1-9
2328-8957
2328-8957
CONICET Digital
CONICET
url http://hdl.handle.net/11336/88583
identifier_str_mv Goss, William Miller; Seas, Carlos; Carvajal, Lina P.; Diaz, Lorena; Echeverri, Aura M.; et al.; The cefazolin inoculum effect is associated with increased mortality in methicillin-susceptible staphylococcus aureus bacteremia; Oxford University Press; Open Forum Infectious Diseases; 5; 6; 5-2018; 1-9
2328-8957
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1093/ofid/ofy123
info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/ofid/article/5/6/ofy123/5003417
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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