Evolution of Ceftaroline-Resistant Mrsa in a Child with Cystic Fibrosis Following Repeated Antibiotic Exposure

Pediatr Infect Dis J. 2016 Jul;35(7):813-5. doi: 10.1097/INF.0000000000001171.

Abstract

Ceftaroline is the first β-lactam antibiotic with activity against methicillin-resistant Staphylococcus aureus (MRSA). We describe a ceftaroline-resistant MRSA strain, isolated from a girl with cystic fibrosis after 22 ceftaroline treatment courses. MRSA genome sequencing documented a Tyr446Asn alteration in penicillin binding protein 2 that appeared responsible for resistance. Noncompartmental ceftaroline pharmacokinetic evaluation in our patient documented increased clearance and volume of distribution compared with adults.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / pharmacokinetics
  • Base Sequence
  • Cephalosporins / administration & dosage*
  • Cephalosporins / adverse effects
  • Cephalosporins / pharmacokinetics
  • Child, Preschool
  • Cystic Fibrosis / metabolism
  • Cystic Fibrosis / microbiology*
  • DNA, Bacterial / genetics
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests
  • Mutation
  • Penicillin-Binding Proteins / genetics
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / metabolism
  • Staphylococcal Infections / microbiology*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • DNA, Bacterial
  • Penicillin-Binding Proteins