Susceptibility and Synergy Studies of Methicillin-Resistant Staphylococcus epidermidis

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Published inAntimicrobial Agents and Chemotherapy Vol. 16; no. 5; pp. 655 - 659
Main Authors Ein, M E, Smith, N J, Aruffo, J F, Heerema, M S, Bradshaw, M W, Williams, Jr, T W
Format Journal Article
LanguageEnglish
Published United States American Society for Microbiology 01.11.1979
Subjects
Anti-Bacterial Agents
Anti-Bacterial Agents - pharmacology
Cefamandole - pharmacology
Cephalothin - pharmacology
Drug Synergism
Methicillin
Methicillin - pharmacology
Microbial Sensitivity Tests
Penicillin Resistance
Physiological Effects and Microbial Susceptibility
Rifampin - pharmacology
Staphylococcus
Staphylococcus - drug effects
Time Factors
Vancomycin - pharmacology
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Abstract Classifications Services AAC Citing Articles Google Scholar PubMed Related Content Social Bookmarking CiteULike Delicious Digg Facebook Google+ Mendeley Reddit StumbleUpon Twitter current issue AAC About AAC Subscribers Authors Reviewers Advertisers Inquiries from the Press Permissions & Commercial Reprints ASM Journals Public Access Policy AAC RSS Feeds 1752 N Street N.W. • Washington DC 20036 202.737.3600 • 202.942.9355 fax • journals@asmusa.org Print ISSN: 0066-4804 Online ISSN: 1098-6596 Copyright © 2014 by the American Society for Microbiology.   For an alternate route to AAC .asm.org, visit: AAC       
AbstractList Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution minimum inhibitory concentrations were determined for 100 strains of methicillin-resistant S. epidermidis which were isolated from clinical specimens. Vancomycin inhibited all 100 strains at ≤3.12 μg/ml, whereas clindamycin inhibited only 46 strains at ≤12.5 μg/ml. Methicillin-resistant S. epidermidis strains were resistant to achievable levels of erythromycin, with 90 strains having a minimum inhibitory concentration of ≥3.12 μg/ml. Of the five cephalosporins and one cephamycin tested, cefamandole was the most active in vitro, inhibiting 97 strains at ≤25 μg/ml. Antibiotic synergism was examined by a quantitative bacterial time-kill method. Synergism (≥10 2 kill by the combination over the most effective single antibiotic at 24 h) was demonstrated with vancomycin (1.56 μg/ml) plus cefamandole (6.25 μg/ml) in 14 of 14 strains, vancomycin plus cephalothin (6.25 μg/ml) in 14 of 14 strains, vancomycin plus rifampin (0.008 to 0.012 μg/ml) in 6 of 12 strains, rifampin plus cefamandole in 9 of 12 strains, and rifampin plus cephalothin in 10 of 12 strains. The emergence of populations of bacteria resistant to 0.2 μg of rifampin per ml developed in three of five methicillin-resistant S. epidermidis strains tested. The addition of either vancomycin, cephalothin, or cefamandole to the rifampin prevented the emergence of resistance in these three strains. Clinical trials of synergistic antibiotic combination therapy for serious methicillin-resistant S. epidermidis infections are indicated.
Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution minimum inhibitory concentrations were determined for 100 strains of methicillin-resistant S. epidermidis which were isolated from clinical specimens. Vancomycin inhibited all 100 strains at </=3.12 mug/ml, whereas clindamycin inhibited only 46 strains at </=12.5 mug/ml. Methicillin-resistant S. epidermidis strains were resistant to achievable levels of erythromycin, with 90 strains having a minimum inhibitory concentration of >/=3.12 mug/ml. Of the five cephalosporins and one cephamycin tested, cefamandole was the most active in vitro, inhibiting 97 strains at </=25 mug/ml. Antibiotic synergism was examined by a quantitative bacterial time-kill method. Synergism (>/=10(2) kill by the combination over the most effective single antibiotic at 24 h) was demonstrated with vancomycin (1.56 mug/ml) plus cefamandole (6.25 mug/ml) in 14 of 14 strains, vancomycin plus cephalothin (6.25 mug/ml) in 14 of 14 strains, vancomycin plus rifampin (0.008 to 0.012 mug/ml) in 6 of 12 strains, rifampin plus cefamandole in 9 of 12 strains, and rifampin plus cephalothin in 10 of 12 strains. The emergence of populations of bacteria resistant to 0.2 mug of rifampin per ml developed in three of five methicillin-resistant S. epidermidis strains tested. The addition of either vancomycin, cephalothin, or cefamandole to the rifampin prevented the emergence of resistance in these three strains. Clinical trials of synergistic antibiotic combination therapy for serious methicillin-resistant S. epidermidis infections are indicated.
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Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution minimum inhibitory concentrations were determined for 100 strains of methicillin-resistant S. epidermidis which were isolated from clinical specimens. Vancomycin inhibited all 100 strains at ≤3.12 μg/ml, whereas clindamycin inhibited only 46 strains at ≤12.5 μg/ml. Methicillin-resistant S. epidermidis strains were resistant to achievable levels of erythromycin, with 90 strains having a minimum inhibitory concentration of ≥3.12 μg/ml. Of the five cephalosporins and one cephamycin tested, cefamandole was the most active in vitro, inhibiting 97 strains at ≤25 μg/ml. Antibiotic synergism was examined by a quantitative bacterial time-kill method. Synergism (≥102 kill by the combination over the most effective single antibiotic at 24 h) was demonstrated with vancomycin (1.56 μg/ml) plus cefamandole (6.25 μg/ml) in 14 of 14 strains, vancomycin plus cephalothin (6.25 μg/ml) in 14 of 14 strains, vancomycin plus rifampin (0.008 to 0.012 μg/ml) in 6 of 12 strains, rifampin plus cefamandole in 9 of 12 strains, and rifampin plus cephalothin in 10 of 12 strains. The emergence of populations of bacteria resistant to 0.2 μg of rifampin per ml developed in three of five methicillin-resistant S. epidermidis strains tested. The addition of either vancomycin, cephalothin, or cefamandole to the rifampin prevented the emergence of resistance in these three strains. Clinical trials of synergistic antibiotic combination therapy for serious methicillin-resistant S. epidermidis infections are indicated.
Author Major W. Bradshaw
Temple W. Williams Jr
John F. Aruffo
Mark S. Heerema
Michael E. Ein
Nedra J. Smith
AuthorAffiliation Departments of Medicine and Microbiology-Immunology, Baylor College of Medicine, Houston, Texas 77030
Infectious Disease Laboratory, The Methodist Hospital, Baylor College of Medicine, Houston, Texas 77030
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Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution...
Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution...
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StartPage 655
SubjectTerms Anti-Bacterial Agents
Anti-Bacterial Agents - pharmacology
Cefamandole - pharmacology
Cephalothin - pharmacology
Drug Synergism
Methicillin
Methicillin - pharmacology
Microbial Sensitivity Tests
Penicillin Resistance
Physiological Effects and Microbial Susceptibility
Rifampin - pharmacology
Staphylococcus
Staphylococcus - drug effects
Time Factors
Vancomycin - pharmacology
Title Susceptibility and Synergy Studies of Methicillin-Resistant Staphylococcus epidermidis
URI http://aac.asm.org/content/16/5/655.abstract
https://www.ncbi.nlm.nih.gov/pubmed/260880
https://journals.asm.org/doi/10.1128/AAC.16.5.655
https://pubmed.ncbi.nlm.nih.gov/PMC352924
Volume 16
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