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Susceptibility

Activity of Telavancin against Staphylococcus aureus Isolates, Including Those with Decreased Susceptibility to Ceftaroline, from Cystic Fibrosis Patients

Melanie Roch, Maria Celeste Varela, Agustina Taglialegna, Warren E. Rose, Adriana E. Rosato
Melanie Roch
aDepartment of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, Texas, USA
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Maria Celeste Varela
aDepartment of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, Texas, USA
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Agustina Taglialegna
aDepartment of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, Texas, USA
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Warren E. Rose
bSchool of Pharmacy, University of Wisconsin—Madison, Madison, Wisconsin, USA
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Adriana E. Rosato
aDepartment of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, Texas, USA
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DOI: 10.1128/AAC.00956-18
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ABSTRACT

Methicillin-resistant Staphylococcus aureus (MRSA) acquisition in cystic fibrosis (CF) patients confers a clinical outcome worse than that in non-CF patients with an increased rate of declined lung function. Telavancin, an approved lipoglycopeptide used to treat infections due to S. aureus, has a dual mode of action causing inhibition of peptidoglycan synthesis and membrane depolarization. MRSA infections in CF patients remain an important problem with no foreseeable decline in prevalence rates. Although telavancin is currently in clinical use for the treatment of complicated skin infections and hospital-acquired pneumonia, the activity against S. aureus infections in CF patients has not been investigated. In this work, we studied the activity of telavancin against CF patient-derived S. aureus strains collected from geographically diverse CF centers in the United States. We found that the telavancin MIC90 was 0.06 μg/ml, 8-fold lower than the ceftaroline or daptomycin MIC90 and 25-fold lower than the linezolid and vancomycin MIC90. We demonstrate that telavancin at serum free concentrations has rapid bactericidal activity, with a decrease of more than 3 log10 CFU/ml being achieved during the first 4 to 6 h of treatment, performing better in this assay than vancomycin and ceftaroline, including against S. aureus strains resistant to ceftaroline. Telavancin resistance was infrequent (0.3%), although we found that it can occur in vitro in both CF- and non-CF patient-derived S. aureus strains by progressive passages with subinhibitory concentrations. Genetic analysis of telavancin-resistant in vitro mutants showed gene polymorphisms in cell wall and virulence genes and increased survival in a Galleria mellonella infection model. Thus, we conclude that telavancin represents a promising therapeutic option for infections in CF patients with potent in vitro activity and a low resistance development potential.

  • Copyright © 2018 Roch et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

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Activity of Telavancin against Staphylococcus aureus Isolates, Including Those with Decreased Susceptibility to Ceftaroline, from Cystic Fibrosis Patients
Melanie Roch, Maria Celeste Varela, Agustina Taglialegna, Warren E. Rose, Adriana E. Rosato
Antimicrobial Agents and Chemotherapy Aug 2018, 62 (9) e00956-18; DOI: 10.1128/AAC.00956-18

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Activity of Telavancin against Staphylococcus aureus Isolates, Including Those with Decreased Susceptibility to Ceftaroline, from Cystic Fibrosis Patients
Melanie Roch, Maria Celeste Varela, Agustina Taglialegna, Warren E. Rose, Adriana E. Rosato
Antimicrobial Agents and Chemotherapy Aug 2018, 62 (9) e00956-18; DOI: 10.1128/AAC.00956-18
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KEYWORDS

cystic fibrosis
chronic infections
MRSA
telavancin

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