Prevalence of the Cefazolin Inoculum Effect (CzIE) in Nasal Colonizing Methicillin-Susceptible Staphylococcus aureus in Patients from Intensive Care Units in Colombia and Use of a Modified Rapid Nitrocefin Test for Detection.

Autor:	Carvajal LP; Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia., Rincon S; Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia., Gomez-Villegas SI; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Matiz-González JM; Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia., Ordoñez K; Department of Infectious Diseases, ESE Hospital Universitario, San Jorge de Pereira, Pereira, Colombia., Santamaria A; Department of Infectious Diseases, ESE Hospital Universitario, San Jorge de Pereira, Pereira, Colombia., Ospina-Navarro L; Clinica Colsubsidio Calle 100, Bogota, Colombia., Beltran J; Clinica Colsubsidio Calle 100, Bogota, Colombia., Guevara F; Servicio de Infectología, Fundación Santafe de Bogota, Bogota, Colombia.; Clinica Reina Sofia, Colsanitas, Bogota, Colombia., Mendez YR; Grupo de Investigacion en Epidemiologia Clinica de Colombia (GRECO), Universidad Pedagogica y Tecnologica de Colombia, Tunja, Colombia.; Hospital Regional de Duitama, Duitama, Colombia., Salcedo S; Organizacion Clinica General del Norte, Barranquilla, Colombia., Porras A; Los Cobos Medical Center, Bogota, Colombia., Valencia-Moreno A; Los Cobos Medical Center, Bogota, Colombia., Grennia H; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA., Deyanov A; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA., Baptista R; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA.; Division of Infectious Diseases and Department of Medicine, Houston Methodist Hospital, Houston, TX USA 77030.; Department of Medicine, Weill Cornell Medical College, New York, NY., Tam VH; Departament of Pharmacy Practice and Translational Research, University of Houston, Houston, Texas, United States., Panesso D; Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia.; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA.; Division of Infectious Diseases and Department of Medicine, Houston Methodist Hospital, Houston, TX USA 77030.; Department of Medicine, Weill Cornell Medical College, New York, NY., Tran TT; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA.; Division of Infectious Diseases and Department of Medicine, Houston Methodist Hospital, Houston, TX USA 77030.; Department of Medicine, Weill Cornell Medical College, New York, NY., Miller WR; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA.; Division of Infectious Diseases and Department of Medicine, Houston Methodist Hospital, Houston, TX USA 77030.; Department of Medicine, Weill Cornell Medical College, New York, NY., Arias CA; Center for Infectious Disease, Houston Methodist Research Institute, Houston, TX USA.; Division of Infectious Diseases and Department of Medicine, Houston Methodist Hospital, Houston, TX USA 77030.; Department of Medicine, Weill Cornell Medical College, New York, NY., Reyes J; Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2024 Jul 11. Date of Electronic Publication: 2024 Jul 11.
DOI:	10.1101/2024.07.11.24309236
Abstrakt:	The cefazolin inoculum effect (CzIE) has been associated with poor clinical outcomes in patients with MSSA infections. We aimed to investigate the point prevalence of the CzIE among nasal colonizing MSSA isolates from ICU patients in a multicenter study in Colombia (2019-2023). Patients underwent nasal swabs to assess for S. aureus colonization on admission to the ICU and some individuals had follow-up swabs. We performed cefazolin MIC by broth-microdilution using standard and high-inoculum and developed a modified nitrocefin-based rapid test to detect the CzIE. Whole genome sequencing was carried out to characterize BlaZ types and allotypes, phylogenomics and Agr-typing. All swabs were subjected to 16S-rRNA metabarcoding sequencing to evaluate microbiome characteristics associated with the CzIE. A total of 352 patients were included; 46/352 (13%) patients were colonized with S. aureus; 22% (10/46) and 78% (36/46) with MRSA and MSSA, respectively. Among 36 patients that contributed with 43 MSSA colonizing isolates, 21/36 (58%) had MSSA exhibiting the CzIE. BlaZ type A and BlaZ-2 were the predominant type and allotype in 56% and 52%, respectively. MSSA belonging to CC30 were highly associated with the CzIE and SNP analyses supported transmission of MSSA exhibiting the CzIE among some patients of the same unit. The modified nitrocefin rapid test had 100%, 94.4% and 97.7% sensitivity, specificity and accuracy, respectively. We found a high prevalence point prevalence of the CzIE in MSSA colonizing the nares of critically-ill patients in Colombia. A modified rapid test was highly accurate in detecting the CzIE in this patient population.
Databáze:	MEDLINE
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