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Epidemiology and Surveillance

Antimicrobial Activity of Dalbavancin against Staphylococcus aureus with Decreased Susceptibility to Glycopeptides, Daptomycin, and/or Linezolid from U.S. Medical Centers

Helio S. Sader, Rodrigo E. Mendes, Leonard R. Duncan, Michael A. Pfaller, Robert K. Flamm
Helio S. Sader
aJMI Laboratories, North Liberty, Iowa, USA
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Rodrigo E. Mendes
aJMI Laboratories, North Liberty, Iowa, USA
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Leonard R. Duncan
aJMI Laboratories, North Liberty, Iowa, USA
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Michael A. Pfaller
aJMI Laboratories, North Liberty, Iowa, USA
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Robert K. Flamm
aJMI Laboratories, North Liberty, Iowa, USA
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DOI: 10.1128/AAC.02397-17
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    FIG 1

    Summary of dalbavancin activity when tested against S. aureus isolates with decreased susceptibility to glycopeptides, daptomycin, and/or linezolid from U.S. medical centers. Abbreviations: VAN ≥2, isolates with vancomycin MICs of ≥2 mg/liter; DAPTO-NS, daptomycin nonsusceptible (MIC, ≥2 mg/liter); TLV ≥0.12 mg/liter, isolates with telavancin MICs of ≥0.12 mg/liter; TEICO ≥4, isolates with teicoplanin MICs of ≥4 mg/liter; LNZ-R, linezolid resistant.

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  • TABLE 1

    Activity of dalbavancin and comparator antimicrobial agents tested against S. aureus isolates with decreased susceptibility to glycopeptides, daptomycin, and/or linezolid from U.S. medical centers

    Organism subset and antimicrobial agentMIC50 (mg/liter)MIC90 (mg/liter)MIC range (mg/liter)CLSIaEUCASTa
    %S%R%S%R
    Vancomycin MIC ≥2 mg/liter (n = 1,141)
        Dalbavancin0.060.12≤0.03 to 0.599.3b95.54.5
        Daptomycin0.51≤0.12 to 496.896.83.2
        Vancomycin222 to 499.30.09.30.7
        Teicoplanin≤2≤2≤2 to 1699.90.093.56.5
        Linezolid12≤0.12 to >899.60.499.60.4
        Oxacillin>2>2≤0.25 to >226.973.126.973.1
    Daptomycin nonsusceptible (n = 48)
        Dalbavancin0.060.12≤0.03 to 0.595.8b91.78.3
        Daptomycin242 to 40.00.0100.0
        Vancomycin221 to 495.80.095.84.2
        Teicoplanin≤24≤2 to 1697.90.087.512.5
        Linezolid120.5 to 4100.00.0100.00.0
        Oxacillin>2>2≤0.25 to >212.587.512.587.5
    Telavancin MIC ≥0.12 mg/liter (n = 52)c
        Dalbavancin0.060.25≤0.03 to 0.590.4b84.615.4
        Daptomycin0.510.25 to 296.296.23.8
        Vancomycin121 to 498.10.098.11.9
        Telavancin0.120.120.12 to 0.2596.296.23.8
        Teicoplanin≤24≤2 to 1698.10.076.923.1
        Linezolid110.25 to 2100.00.0100.00.0
        Oxacillin>2>2≤0.25 to >234.665.434.665.4
    Teicoplanin MIC ≥4 mg/liter (n = 143)
        Dalbavancin0.060.25≤0.03 to 0.595.1b83.916.1
        Daptomycin0.510.12 to 495.895.84.2
        Vancomycin220.5 to 497.90.097.92.1
        Teicoplanin484 to 1699.30.00.0100.0
        Linezolid120.25 to 4100.00.0100.00.0
        Oxacillin>2>2≤0.25 to >226.673.426.673.4
    Linezolid resistant (n = 25)
        Dalbavancin0.060.06≤0.03 to 0.12100.0b100.00.0
        Daptomycin0.50.50.25 to 0.5100.0100.00.0
        Vancomycin120.5 to 2100.00.0100.00.0
        Teicoplanin≤2≤2≤2 to ≤2100.00.0100.00.0
        Linezolid8>88 to >80.0100.00.0100.0
        Oxacillin>2>2≤0.25 to >24.096.04.096.0
    • ↵a Criteria as published by CLSI (11) and EUCAST (12). S, susceptible; R, resistant.

    • ↵b Breakpoints from FDA package insert, i.e., susceptible at ≤0.25 mg/liter (13).

    • ↵c Telavancin was only tested against isolates collected in 2011 to 2016.

  • TABLE 2

    Summary of dalbavancin activity tested against S. aureus isolates with decreased susceptibility to glycopeptides, daptomycin, and/or linezolid from U.S. medical centers

    Resistance phenotypeNo. of isolates (cumulative %) inhibited at dalbavancin MIC (mg/liter) ofa:MIC50 (mg/liter)MIC90 (mg/liter)
    ≤0.030.060.120.250.5
    Vancomycin MIC ≥2 mg/liter (n = 1,141)117 (10.3)697 (71.3)276 (95.5)43 (99.3)8 (100.0)0.060.12
    Daptomycin nonsusceptible (n = 48)3 (6.3)25 (58.3)16 (91.7)2 (95.8)2 (100.0)0.060.12
    Telavancin MIC ≥0.12 mg/liter (n = 52)b4 (7.7)24 (53.8)16 (84.6)3 (90.4)5 (100.0)0.0.60.25
    Teicoplanin MIC ≥4 mg/liter (n = 143)14 (9.8)73 (60.8)33 (83.9)16 (95.1)7 (100.0)0.060.25
    Linezolid resistant (n = 25)5 (20.0)18 (92.0)2 (100.0)0.060.06
    All isolates (n = 59,903)22,066 (36.8)33,879 (93.4)3,795 (99.7)155 (>99.9)8 (100.0)0.060.06
    • ↵a Boldface data represent dalbavancin modal MIC results. The dalbavancin-susceptible breakpoint approved by the FDA for S. aureus is ≤0.25 mg/liter (13).

    • ↵b Telavancin was only tested against isolates collected in 2011 to 2016.

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Antimicrobial Activity of Dalbavancin against Staphylococcus aureus with Decreased Susceptibility to Glycopeptides, Daptomycin, and/or Linezolid from U.S. Medical Centers
Helio S. Sader, Rodrigo E. Mendes, Leonard R. Duncan, Michael A. Pfaller, Robert K. Flamm
Antimicrobial Agents and Chemotherapy Feb 2018, 62 (3) e02397-17; DOI: 10.1128/AAC.02397-17

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Antimicrobial Activity of Dalbavancin against Staphylococcus aureus with Decreased Susceptibility to Glycopeptides, Daptomycin, and/or Linezolid from U.S. Medical Centers
Helio S. Sader, Rodrigo E. Mendes, Leonard R. Duncan, Michael A. Pfaller, Robert K. Flamm
Antimicrobial Agents and Chemotherapy Feb 2018, 62 (3) e02397-17; DOI: 10.1128/AAC.02397-17
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KEYWORDS

glycopeptides
lipoglycopeptides
vancomycin-intermediate S. aureus

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