liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Heterogeneous glycopeptide intermediate Staphylococcus epidermidis isolated from prosthetic joint infections
Karlstad Hospital, Sweden / Örebro University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Microbiology.
Örebro University Hospital, Sweden.
Örebro University / Örebro University Hospital, Sweden.
Show others and affiliations
2014 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 33, no 6, 911-917 p.Article in journal (Refereed) Published
Abstract [en]

Methicillin-resistant Staphylococcus epidermidis (MRSE) poses a major problem in prosthetic joint infections (PJIs). Vancomycin is often considered the drug of choice in the empirical treatment of staphylococcal PJIs. As recent decades have seen reports of heterogeneous glycopeptide intermediate S. aureus (hGISA), our aim was to examine the prevalence of heterogeneous glycopeptide intermediate S. epidermidis (hGISE) in PJIs. S. epidermidis isolates (n = 122) from 119 patients in three Swedish counties between 1993 and 2012 were included. All were isolated from perioperative tissue samples from revision surgery in clinically verified PJIs. Antimicrobial susceptibility testing against staphylococcal antibiotics was performed. The macromethod Etest (MME) and glycopeptide resistance detection (GRD) Etest were used to detect hGISE. Standard minimal inhibitory concentration (MIC) determination revealed no vancomycin-resistant isolates, while teicoplanin resistance was detected in 14 out of 122 isolates (11.5 %). hGISE was found in 95 out of 122 isolates (77.9 %), 64 out of 67 of isolates with teicoplanin MIC >2 mg/L (95.5 %) and 31 out of 55 of isolates with teicoplanin MIC ≤2 mg/L (56.4 %). Thus, the presence of hGISE cannot be ruled out by teicoplanin MIC ≤2 mg/L alone. Multidrug resistance was detected in 86 out of 95 hGISE isolates (90.5 %) and in 16 out of 27 isolates (59.3 %), where hGISE could not be detected. In conclusion, hGISE detected by MME or GRD was common in this material. However, hGISE is difficult to detect with standard laboratory diagnostic routines. Glycopeptide treatment may not be sufficient in many of these PJIs, even if standard MIC classifies the isolated S. epidermidis as susceptible.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2014. Vol. 33, no 6, 911-917 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-105484DOI: 10.1007/s10096-013-2025-3ISI: 000335743500004OAI: diva2:707675
Available from: 2014-03-25 Created: 2014-03-25 Last updated: 2015-03-27

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Claesson, CarinaNilsdotter-Augustinsson, Åsa
By organisation
Division of Microbiology and Molecular MedicineFaculty of Health SciencesDepartment of Clinical MicrobiologyDepartment of Infectious Diseases
In the same journal
European Journal of Clinical Microbiology and Infectious Diseases
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 64 hits
ReferencesLink to record
Permanent link

Direct link