From the Research
Staphylococcus caprae infections should be treated with combination therapy of daptomycin and ceftaroline, as this regimen has shown promise in reducing clinical failure and improving outcomes in complicated methicillin-resistant Staphylococcus aureus bacteremia, and may be applicable to S. caprae infections as well 1.
Overview of Staphylococcus caprae
Staphylococcus caprae is a coagulase-negative staphylococcal species that primarily colonizes goats but can cause infections in humans. It is commonly found on human skin and mucous membranes as part of the normal flora. S. caprae can cause opportunistic infections, particularly in immunocompromised patients or those with implanted medical devices. These infections may include bacteremia, endocarditis, urinary tract infections, bone and joint infections, and catheter-related infections.
Treatment Options
Treatment typically involves antibiotics such as vancomycin, linezolid, or daptomycin, with specific regimens depending on infection severity and antimicrobial susceptibility testing. For serious infections, vancomycin 15-20 mg/kg IV every 8-12 hours for 2-6 weeks is often used. Milder infections may be treated with oral antibiotics like trimethoprim-sulfamethoxazole or doxycycline. However, combination therapy with daptomycin and ceftaroline may be a more effective option, as it has shown synergistic bactericidal activity and improved outcomes in complicated MRSA bacteremia 1.
Challenges in Treatment
S. caprae can form biofilms on medical devices, making treatment challenging and sometimes requiring device removal. The bacterium has shown increasing resistance to antibiotics, including methicillin, so susceptibility testing is crucial for effective treatment. Ceftaroline has demonstrated potent in vitro activity against staphylococci with reduced susceptibility to linezolid, daptomycin, or vancomycin, making it a valuable treatment option for infections caused by these multidrug-resistant staphylococci 2.
Key Considerations
- Staphylococcus caprae infections can be challenging to treat due to antibiotic resistance and biofilm formation.
- Combination therapy with daptomycin and ceftaroline may be a more effective option for complicated infections.
- Susceptibility testing is crucial for effective treatment, and ceftaroline may be a valuable option for infections caused by multidrug-resistant staphylococci.
- The most recent and highest quality study suggests that combination therapy with daptomycin and ceftaroline is associated with lower odds of clinical failure in complicated MRSA bacteremia, and may be applicable to S. caprae infections as well 1.