{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:46:01Z","timestamp":1781775961406,"version":"3.54.5"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T00:00:00Z","timestamp":1692403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Institute of Infectious Diseases and Epidemiology","award":["CGSFP15003"],"award-info":[{"award-number":["CGSFP15003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The blaZ gene encodes penicillinase, which inactivates penicillin. As there were reports on suboptimal sensitivity for the penicillin zone-edge test, a phenotypic method for blaZ detection, we investigated treatment outcomes in patients with penicillin-susceptible Staphylococcus aureus (PSSA) bacteraemia (phenotypically negative for penicillinase), subjecting isolates to molecular testing for blaZ retrospectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>A retrospective cohort study was conducted on 121 patients with a first episode of PSSA bacteraemia from 1 January 2012 to 31 October 2015 at Tan Tock Seng Hospital (TTSH), Singapore. Patients were grouped into IV benzylpenicillin and non-benzylpenicillin groups. The primary outcome was overall treatment failure, defined as either 30 day all-cause mortality and\/or 90 day relapse. The penicillin (P10) zone-edge test was repeated on archived PSSA isolates, concurrently with penicillin MIC determination via gradient diffusion and PCR for blaZ.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 121 patients, 57 patients (47.1%) received IV benzylpenicillin as the predominant antibiotic. There was no significant difference in overall treatment failure between treatment with the benzylpenicillin [7\/57 (12.3%)] versus non-benzylpenicillin groups [12\/64 (18.8%)] (P\u200a=\u200a0.33) or cloxacillin\/cefazolin [6\/37 (16.2%)] (P\u200a=\u200a0.59). For 112 PSSA isolates available for testing, repeat penicillin zone-edge testing was negative for penicillinase production, corroborating previous results. A single PSSA isolate with a negative penicillin zone-edge test was found to be positive for blaZ.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found no differences in overall treatment failure between patients with PSSA bacteraemia treated with benzylpenicillin, anti-staphylococcal \u03b2-lactams cefazolin\/cloxacillin and other antimicrobials, when using the penicillin zone-edge test as the phenotypic method for blaZ screening.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad263","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T09:59:35Z","timestamp":1692439175000},"page":"2515-2523","source":"Crossref","is-referenced-by-count":16,"title":["Treatment outcomes with benzylpenicillin and non-benzylpenicillin antibiotics, and the performance of the penicillin zone-edge test versus molecular detection of <i>blaZ<\/i> in penicillin-susceptible <i>Staphylococcus aureus<\/i> (PSSA) bacteraemia"],"prefix":"10.1093","volume":"78","author":[{"given":"Hoi Tong","family":"Mok","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine B","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore"},{"name":"Department of Pharmacy, The National University of Singapore, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Bergin","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore"},{"name":"Department of Microbiology, Tallaght University Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei Yun","family":"Hon","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Laboratory, National Centre for Infectious Diseases, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Lye","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore"},{"name":"Infectious Diseases Research and Training Office, National Centre for Infectious Diseases, Singapore, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partha P","family":"De","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7812-9881","authenticated-orcid":false,"given":"Shawn","family":"Vasoo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Laboratory, National Centre for Infectious Diseases, Singapore, Singapore"},{"name":"Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore"},{"name":"Infectious Diseases Research and Training Office, National Centre for Infectious Diseases, Singapore, Singapore"},{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,19]]},"reference":[{"key":"2023100302094059500_dkad263-B1","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1172\/JCI18535","article-title":"Antimicrobial resistance: the example of Staphylococcus aureus","volume":"111","author":"Lowy","year":"2003","journal-title":"J Clin Invest"},{"key":"2023100302094059500_dkad263-B2","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1093\/jac\/dkt317","article-title":"Resurgence of penicillin-susceptible Staphylococcus aureus at a hospital in New York State, USA","volume":"69","author":"Crane","year":"2014","journal-title":"J Antimicrob Chemother"},{"key":"2023100302094059500_dkad263-B3","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.jiac.2019.10.023","article-title":"Comparison of penicillins (penicillin G and ampicillin) and cefazolin as a definitive therapy against penicillin-susceptible Staphylococcus aureus (PSSA) bacteremia in Japan: a retrospective cohort study","volume":"26","author":"Moriyama","year":"2020","journal-title":"J Infect Chemother"},{"key":"2023100302094059500_dkad263-B4","doi-asserted-by":"crossref","first-page":"e00680-18","DOI":"10.1128\/AAC.00680-18","article-title":"Increasing rates of penicillin sensitivity in Staphylococcus aureus","volume":"62","author":"Butler-Laporte","year":"2018","journal-title":"Antimicrob Agents Chemother"},{"key":"2023100302094059500_dkad263-B5","first-page":"3353","article-title":"Reappearance and treatment of penicillin-susceptible Staphylococcus aureus in a tertiary medical centre","volume":"70","author":"Chabot","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"2023100302094059500_dkad263-B6","article-title":"Penicillin-susceptible Staphylococcus aureus (PSSA) infection in an era of multidrug 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