Evaluating the Rapid Emergence of Daptomycin Resistance in <em>Corynebacterium</em>: A Multi-Center Study

J Clin Microbiol. 2021 Jan 20:JCM.02052-20. doi: 10.1128/JCM.02052-20. Online ahead of print.

ABSTRACT

Background: Members of the genus Corynebacterium are increasingly recognized as pathobionts and can be very resistant to antimicrobial agents. Previous studies have demonstrated that Corynebacterium striatum can rapidly develop high-level daptomycin resistance (HLDR) (minimum inhibitory concentration [MIC] ≥256 μg/mL). Here we conducted a multi-center study to assay for this in vitro phenotype in diverse Corynebacterium species.Methods: Corynebacterium clinical isolates (n=157) from four medical centers were evaluated. MIC values to daptomycin, vancomycin, and telavancin were determined before and after overnight exposure to daptomycin to identify isolates able to rapidly develop daptomycin non-susceptibility. To investigate assay reproducibility, 18 isolates were evaluated at three study sites. In addition, stability of daptomycin non-susceptibility was tested using repeated subculture without selective pressure. The impact of different media brands was also investigated.Results: Daptomycin non-susceptibility emerged in 12 of 23 species evaluated in this study (C. afermentans, amycolatum, aurimucosum, bovis, jeikeium, macginleyi, pseudodiphtheriticum, resistens, simulans, striatum, tuberculostearicum, and ulcerans) and was detected in 50 of 157 (31.8%) isolates tested. All isolates displayed low (susceptible) MIC values to vancomycin and telavancin before and after daptomycin exposure. Repeated subculture demonstrated 2 of 9 isolates (22.2%) exhibiting HLDR reverted to a susceptible phenotype. Of 30 isolates tested on three media brands, 13 (43.3%) had differences in daptomycin MIC values between brands.Conclusions: Multiple Corynebacterium species can rapidly develop daptomycin non-susceptibility, including HLDR, after a short daptomycin exposure period.

PMID:33472898 | DOI:10.1128/JCM.02052-20