Coagulase-negative staphylococci in outpatient routines: the implications of switching from CLSI to BrCAST/EUCAST guidel
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CLINICAL MICROBIOLOGY - RESEARCH PAPER
Coagulase-negative staphylococci in outpatient routines: the implications of switching from CLSI to BrCAST/EUCAST guidelines Vinícius Pietta Perez 1 & Jéssica Karoliny Baptista Porto Carvalho 2 & Marianne Schrader de Oliveira 3 & Adriana Medianeira Rossato 4 & Caroline Dani 2 & Gertrudes Corção 5 & Pedro Alves d’Azevedo 4 Received: 5 September 2019 / Accepted: 16 April 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract Coagulase-negative staphylococci (CoNS) are frequently isolated in clinical specimens and are important reservoirs of resistance genes. In 2019, the Brazilian government set the BrCAST/EUCAST (Brazilian Committee on Antimicrobial Susceptibility Testing) guidelines as the national standard, resulting in changes in the interpretation of CoNS susceptibility tests. From outpatients, disk-diffusion susceptibility of 65 CoNS cultures were evaluated and compared using classification criteria from both CLSI and BrCAST/EUCAST. The isolates were identified using matrix assisted laser desorption ionization–time of flight (MALDI-TOF), and the presence of the mecA gene was determined. The most prevalent species were Staphylococcus saprophyticus (32.3%), S. haemolyticus (18.5%), and S. epidermidis (9.2%). Almost perfect agreement was seen between the guidelines, except concerning oxacillin and gentamicin, and the prevalence of multidrug resistant isolates increased with the use of BrCAST/EUCAST. Of all, 15 (23.1%) isolates, mainly S. epidermidis and S. haemolyticus, were positive for the mecA gene, and only three were detected when using CLSI or BrCAST/EUCAST disk-diffusion screening. This, using either guideline, could reveal the difficulty of determining oxacillin resistance. Using warning zones or molecular methods might well be indicated for CoNS. In conclusion, adoption of the BrCAST/EUCAST guidelines will result in certain artificial changes in epidemiological susceptibility profiles, and clinicians and institutions should be aware of the possible implications. Keywords Antimicrobial susceptibility testing . Brazilian Committee on Antimicrobial Susceptibility Testing . European Committee on Antimicrobial Susceptibility Testing . Clinical Laboratory Standards Institute . Coagulase-negative staphylococci . Oxacillin resistance
Responsible Editor: Afonso Luis Barth. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s42770-020-00278-1) contains supplementary material, which is available to authorized users. * Vinícius Pietta Perez [email protected] 1
Departamento de Fisiologia e Patologia, Universidade Federal da Paraíba, Campus I - Cidade Universitaria, João Pessoa, PB 58051-900, Brazil
2
Curso de Biomedicina, Centro Universitário Metodista IPA, Porto Alegre, Brazil
3
Laboratório Endocrimeta, Porto Alegre, Brazil
4
Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
5
Departamento de Microbiologia, Imunologia e Parasitologia, Univer
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