Teicoplanin non-susceptible coagulase-negative staphylococci in a large Australian healthcare network: Implications for treatment with vancomycin

Introduction and Objectives: Coagulase-negative staphylococci (CoNS) are relatively low in virulence but some are increasingly recognized as agents of clinically important infections. Glycopeptides are the drugs of choice for treatment of methicillin-resistant CoNS infections. Our aim was to analyse the susceptibility profile of CoNS in our healthcare network from 2010-2012.

Methods: All CoNS with susceptibility results were analysed as two groups; teicoplanin-susceptible (Teico-S) and non–susceptible (Teico-NS). Analysis included results of other antistaphylococcal antibiotic susceptibilities, sample type (sterile, non-sterile), species and patient location (intensive care unit (ICU) vs non-ICU).

Results: Of the 1510 CoNS isolates with susceptibility results, 109 (7.2%) were non-susceptible to teicoplanin. Teicoplanin non-susceptibility was associated with non-susceptibility to ≥ 3 antistaphylococcal-antibiotics, detected more frequently from sterile samples compared to non-sterile samples and from ICU compared to ward patients. Staphylococcus epidermidis was the most common species recovered and was more likely to be Teico-NS.

Conclusions: Teicoplanin non-susceptibility is associated with multi-resistance to ≥3 antistaphylococcal antibiotics. Clinicians should be aware that vancomycin resistance may be selected from Teico-NS strains.