Antimicrobial susceptibility of coagulase-negative staphylococci and characterization of isolates with reduced susceptibility to glycopeptides

Alamo, Lilian Del’; Cereda, Rosângela Ferraz; Tosin, Iraci; Miranda, Eliete A; Sader, Hélio S.

doi:10.1016/s0732-8893(99)00034-6

Cited by 56 publications

(28 citation statements)

References 10 publications

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“…Another advantage of the agar methods is the fact that single colonies growing at higher drug concentrations can be visualized on solid media earlier and more readily than in broth-based systems. Whatever method is employed, it should be noted that inconsistencies have been reported even between gold standard testing methods for detecting vancomycin resistance in staphylococci (18,20).…”

Section: Laboratory Detection Of Vancomycin Resistancementioning

confidence: 99%

Vancomycin Resistance in Staphylococci

2002

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Vancomycin resistance has been reported in clinical isolates of both coagulase-negative staphylococci and Staphylococcus aureus. The emerging threat of widespread vancomycin resistance poses a serious public health concern given the fact that vancomycin has long been the preferred treatment of antibiotic-resistant gram-positive organisms. Though major efforts are now being focused on improving our understanding of vancomycin resistance, there is much that remains unknown at this time. This article reviews the major epidemiologic, microbiologic, and clinical characteristics of vancomycin resistance in both coagulase-negative staphylococci and S. aureus. The review begins with a discussion of issues common to both coagulase-negative staphylococci and S. aureus, such as definitions, laboratory detection of vancomycin resistance, and infection control issues related to vancomycin-resistant staphylococci. The rest of the article is then devoted to a discussion of issues unique to each organism, including epidemiology, risk factors for infection, mechanisms of resistance, and management options

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Section: Laboratory Detection Of Vancomycin Resistancementioning

confidence: 99%

Vancomycin Resistance in Staphylococci

2002

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“…The adhesion of Staphylococcus epidermidis to endothelial cells is enhanced at temperatures encountered during a moderate fever (27), and the internalization of CoNS by host cells (1,7,27) probably contributes to antibiotic failure and infection persistence in some patients. Glycopeptides, especially vancomycin, are the current standard of care for the empirical treatment of suspected methicillin-resistant staphylococcal infections, but staphylococci with reduced susceptibility, tolerance, or resistance to vancomycin have appeared in clinical settings (2,15,19,33), and their frequency is almost certainly underreported due to problems with identification and confusion over breakpoints (2,39).The spread of multidrug-resistant staphylococci mandates the development of novel therapeutic modalities. Of the antistaphylococcal drugs marketed during the past decade, only linezolid has therapeutically useful oral bioavailability; however, this oxazolidinone has been associated with serious toxicity (particularly during prolonged use), is not bactericidal toward staphylococci, and may support the emergence of endogenous resistance during long-term treatment (4,16,24,26,32,34).…”

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confidence: 99%

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confidence: 99%

Antistaphylococcal Activity of Dihydrophthalazine Antifolates, a Family of Novel Antibacterial Drugs

Clark

Ednie

Lin

et al. 2009

Antimicrob Agents Chemother

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For a panel of 153 Staphylococcus aureus clinical isolates (including 13 vancomycin-intermediate or heterogeneous vancomycin-intermediate and 4 vancomycin-resistant strains), MIC 50 s and MIC 90 s of three novel dihydrophthalazine antifolates, BAL0030543, BAL0030544, and BAL0030545, were 0.03 and 0.25 g/ml, respectively, for methicillin-susceptible strains and 0.03 and <0.25 g/ml, respectively, for methicillin-resistant strains. For a panel of 160 coagulase-negative staphylococci (including 5 vancomycin-intermediate and heterogeneous vancomycin-intermediate strains and 7 linezolid-nonsusceptible strains), MIC 50 s and MIC 90 s were <0.03 and <0.06 g/ml, respectively, for methicillin-susceptible strains and 0.06 and 0.5 g/ml, respectively, for methicillin-resistant strains. Vancomycin was active against 93.0% of 313 staphylococci examined; linezolid was active against all S. aureus strains and 95.6% of coagulase-negative staphylococcus strains, whereas elevated MICs of clindamycin, minocycline, trimethoprim, and rifampin for some strains were observed. At 4؋ MIC, the dihydrophthalazines were bactericidal against 11 of 12 staphylococcal strains surveyed. The prolonged serial passage of some staphylococcal strains in the presence of subinhibitory concentrations of BAL0030543, BAL0030544, and BAL0030545 produced clones for which dihydrophthalazines showed high MICs (>128 g/ml), although rates of endogenous resistance development were much lower for the dihydrophthalazines than for trimethoprim. Single-step platings of naïve staphylococci onto media containing dihydrophthalazine antifolates indicated considerable variability among strains with respect to preexistent subpopulations nonsusceptible to dihydrophthalazine antifolates.The prevalence of multidrug-resistant staphylococci (2,18) and the emergence of methicillin-resistant Staphylococcus aureus (MRSA) as a prominent cause of community-acquired skin and skin structure infections (28) are of concern to the medical community. Infections caused by coagulase-negative staphylococci (CoNS), once considered rare, are becoming increasingly frequent, particularly in patients with indwelling medical devices and those who are immunocompromised, and such infections are associated with significant morbidity and mortality (40). The adhesion of Staphylococcus epidermidis to endothelial cells is enhanced at temperatures encountered during a moderate fever (27), and the internalization of CoNS by host cells (1,7,27) probably contributes to antibiotic failure and infection persistence in some patients. Glycopeptides, especially vancomycin, are the current standard of care for the empirical treatment of suspected methicillin-resistant staphylococcal infections, but staphylococci with reduced susceptibility, tolerance, or resistance to vancomycin have appeared in clinical settings (2,15,19,33), and their frequency is almost certainly underreported due to problems with identification and confusion over breakpoints (2,39).The spread of multidrug-resistant staphylococci mandates the ...

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“…As well our study correlating with a study by Shubhrasingh, Gopa Banaerjee et al, where antibiotic susceptibility testing showed maximum resistance to penicillin and ampilicillin80% and 38% strains showed resistance to oxacillin . CONS, primarily S. epidermidis and S. hemolyticus are often resistant to multiple antibiotics and glycopeptides have been considered the drugs of choice for management of infections caused by these organisms (Silvia et al, 1992) and in a study by Del's Alamo, Cereda et al, (1999) showed that glycopeptide resistance is emerging among CONS isolate.…”

Section: Resultsmentioning

confidence: 99%