title: Lack of doxycycline antimalarial prophylaxis impact on Staphylococcus aureus tetracycline resistance.
abstract: There is concern that susceptibility of Staphylococcus aureus to tetracyclines may decrease due to use of antimalarial prophylaxis (doxycycline). We examined characteristics related to tetracycline resistance, including doxycycline exposure, in S. aureus isolates collected via admission surveillance swabs and inpatient clinical cultures from United States military personnel injured during deployment (June 2009-January 2012). Tetracycline class resistance was determined using antimicrobial susceptibility testing. The first S. aureus isolate from 168 patients were analyzed, of which 38 (23%) isolates were resistant to tetracyclines (class). Tetracycline-resistant isolates had a higher proportion of resistance to clindamycin (P=0.019) compared to susceptible isolates. There was no significant difference in tetracycline resistance between isolates collected from patients with and without antimalarial prophylaxis; however, significantly more isolates had tet(M) resistance genes in the doxycycline exposure group (P=0.031). Despite 55% of the patients receiving doxycycline as antimalarial prophylaxis, there was no association with resistance to tetracyclines.
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA. Electronic address: katrin.mende.ctr@mail.mil.
authors.forename: Katrin
authors.initials: K
authors.lastname: Mende
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA.
authors.forename: Miriam L
authors.initials: ML
authors.lastname: Beckius
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Zera
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.affiliation: Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Tribble
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA.
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D018890:Chemoprevention / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D004318:Doxycycline / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008826:Microbial Sensitivity Tests; D008889:Military Personnel; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics; D013753:Tetracycline Resistance; D014481:United States; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D004318:Doxycycline
keywords: Antibiotic resistance; Staphylococcus aureus; Tetracyclines