History and evolution of antibiotic resistance in coagulase-negative staphylococci: Susceptibility profiles of new anti-staphylococcal agents

Figures & data

Table 1 Coagulase-negative staphylococci reported to cause infections in humans1

Species	Common site/type of infection
S. capitis	Urinary tract, skin, blood, CSF shunt
S. caprae	Urinary tract, blood, access sites, prosthetic joints
S. cohnii	Wounds, joints, meninges
S. epidermidis	Widespread sites; wounds, access devices
S. haemolyticus	Native valve, wound, bone, and joint
S. hominis	Blood, lung, breast
S. lugdunensis	Endothelium, heart valves
S. pasteurii	Orthopedic implants
S. saprophiticus	Urinary tract
S. scheiferi	Nosocomial infections, CSF shunts, pacemakers
S. warneri	Widespread sites; neonatal intensive care units
S. xylosus	Blood

1 Derived from Tristan et al (2006) and Koksal et al (2007)

Table 2 List of antimicrobial classes potentially active against coagulase-negative staphylococci

Class
Aminoglycosides
Carbapenems
Cephalosporins
Choramphemicols
Diaminopyrimidines
Fluoroquinolones
Fusidic acid
Glycopeptides
Lincomycins
Lipopeptides
Macrolides
Oxazolidinones
Polymyxins
Rifampicins
Semi-synthetic penicillins
Sulfonamides
Tetracyclines
Dihydrofolate reductase inhibitors (trimethoprim)

Table 3 New agents with good antibacterial activity against coagulase-negative staphylococci

Agent	Year introduced	Mechanism of action	MIC90 CNS MSCNS/MRCNS	MIC90S. aureus MSSA/MRSA	Reference
Ceftibiprole	N.A.	Binds to abberant penicillin binding protein,PBP-2A	1.0/2.0	0.5/2.0	Bogdanovich et al 2005a
Daptomycin	2003	Cell membrane lysis	0.5/0.5	0.5/0.5	Critchley et al 2003Petersen et al 2002
Dalbavancin	N.A.	Blocks cell-wall synthesis like teichoplanin	0.06/0.06	0.06/0.06	Lin et al 2005
Linezolid	2000	Binds to tRNA	4.0/4.0	4.0/4.0	Noskin et al 1999
Moxifloxacin	2002	Interferes with topoisomerase II and IV	0.12/4.0	0.12/4.0	Hardy et al 2000
Televancin	N.A.	Blocks the synthesis of phospholipids in cell membranes	0.5/1.0	0.5/0.5	King et al 2004
Tigecycline	2003	Blocks 30s ribosome	0.5/0.5	0.5/0.5	Frische et al 2004 Gales et al 2005Sader et al 2005

Abbreviations: CNS, coagulase-negative staphylococci; MSCNS/MRCNS, methicillin-susceptible/methicillin-resistant CNS; MSSA/MRSA, methicillin-susceptible S. aureus/methicillin-resistant S. aureus.

Table 4 Ideal characteristics of anti-coagulase-negative staphylococcal antimicrobials

Ease of synthesis, isolation Evidence that bactericidal concentration (MBC) closely approaches the inhibitory concentrations (MIC) Excellent extracellular and intracellular activity Pharmacokinetics/pharmacodynamics favorable to long intermittent dosing Prolonged post-antibiotic effect Good biofilm penetration Potential biofilm inhibition Lack of antagonism with other anti-staphylococcal agents Slow evolution of in vitro and in vivo resistance Low indices of systemic and organ toxicity

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