Trends in antibiotic susceptibility in Staphylococcus aureus in Boston, Massachusetts, 2000-2014.

Trends in antibiotic susceptibility in Staphylococcus aureus in Boston, Massachusetts, 2000-2014.

J Clin Microbiol. 2017 Nov 01;:

Authors: Kanjilal S, Sater MRA, Thayer M, Lagoudas GK, Kim S, Blainey PC, Grad YH

Abstract
The rate of infection by methicillin-resistant S. aureus (MRSA) has declined over the past decade, but it is unclear whether this represents a decline in S. aureus infections overall. To evaluate trends in the annual rates of infection by S. aureus subtype and mean antibiotic resistance, we conducted a 15-year retrospective observational study at two tertiary care institutions in Boston, MA of 31 753 adult inpatients with S. aureus isolated from clinical specimens. We inferred gain and loss of methicillin resistance through genome sequencing of 180 isolates from 2016. Annual rates of infection by S. aureus declined from 2003 to 2014 by 4.2% (2.7%-5.6%), attributable to an annual decline in MRSA of 10.9% (9.3%-12.6%). Penicillin-susceptible S. aureus (PSSA) increased by 6.1% (4.2%-8.1%) annually and rates of methicillin-susceptible, penicillin-resistant S. aureus (MSSA) did not change. Resistance in S. aureus decreased from 2000 to 2014 by 0.8 antibiotics (0.7-0.8). Within common MRSA clonal complexes, 3/14 MSSA and 2/21 PSSA isolates arose from the loss of resistance-conferring genes. Overall, in two tertiary care institutions in Boston, MA, a decline in S. aureus infections has been accompanied by a shift towards increased antibiotic susceptibility. The rise in PSSA makes penicillin an increasingly viable treatment option.

PMID: 29093105 [PubMed - as supplied by publisher]

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