IN VITRO ACTIVITY OF CEFTAROLINE AGAINST GRAM-POSITIVE BACTERIA AND ENTEROBACTERALES WITH EMPHASIS ON MRSA: A SINGLE-CENTER STUDY
DOI:
https://doi.org/10.53582/vdcfhh53Keywords:
Ceftaroline, Methicillin-resistant Staphylococcus aureus, Antimicrobial susceptibility, EnterobacteralesAbstract
Introduction: Antimicrobial resistance (AMR) among Gram-positive pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA), remains a major clinical challenge. Ceftaroline fosamil is a fifth-generation cephalosporin with activity against resistant Gram-positive bacteria, including MRSA.
Aim: To evaluate the in vitro activity of ceftaroline against Gram-positive bacteria and Enterobacterales isolated from clinical specimens.
Material and methods: A two-phase study was conducted at the Institute of Microbiology and Parasitology, Faculty of Medicine in Skopje. The pilot study (July–August 2022) included 144 isolates, while the six-month study (January–June 2023) included 330 isolates from wound and lower respiratory tract specimens. Susceptibility testing was performed using the disk diffusion method according to EUCAST breakpoints.
Results: All methicillin-susceptible Staphylococcus aureus (MSSA; n=133) and MRSA (n=76) isolates demonstrated 100% susceptibility to ceftaroline. Similar susceptibility was observed among coagulase-negative staphylococci and Streptococcus spp. (including S. pyogenes and S. pneumoniae). In contrast, all Enterococcus spp. isolates were resistant to ceftaroline. MRSA isolates were resistant to other tested cephalosporins. Among Enterobacterales, susceptibility varied. Escherichia coli isolates showed 86% susceptibility, while ESBL-producing strains were resistant. Klebsiella pneumoniae isolates demonstrated 60% susceptibility, with all ESBL-producing strains resistant. Susceptibility among Enterobacter spp. ranged from 46% to 63%, and among Proteus mirabilis from 65% to 75%.
Conclusion: Ceftaroline demonstrated excellent in vitro activity against MRSA and MSSA, supporting its role as a potential therapeutic option for resistant Gram-positive infections. However, its activity against Enterobacterales is limited and variable, emphasizing the need for susceptibility-guided use.
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