Tolerance to vancomycin and teicoplanin in 90 clinical isolates of coagulase-negative staphylococci (CoNS) was investigated by time-kill curve methodology. Only six strains, belonging to the Staphylococcus lugdunensis species, exhibited tolerance. The seven other S. lugdunensis strains tested displayed weak susceptibility to the bactericidal activity of glycopeptides compared to the other CoNS. These phenomena are of concern, since S. lugdunensis is recognized as one of the most pathogenic CoNS.Coagulase-negative staphylococci (CoNS) are involved in infections that require bactericidal treatment, such as indwelling foreign body-related infections, endocarditis, and meningitis (4, 10). As CoNS become more resistant to beta-lactams (2), glycopeptides are often considered to be antibiotics of last resort (12). Some investigators, however, have reported glycopeptide tolerance for sporadic CoNS (16,23). Antibiotic tolerance describes a particular "type of resistance" in bacteria capable of surviving, but not growing, in the presence of a normally lethal dose of a given bactericidal antibiotic (20, 21). As early screenings for glycopeptide tolerance in CoNS have been performed by the controversial minimal bactericidal concentration (MBC)/MIC determinations (1,14,19,21), the present study was designed to examine vancomycin and teicoplanin tolerance in a collection of clinically significant CoNS by using the killing curve method, which is considered to be the most reliable method according to the Clinical and Laboratory Standards Institute (CLSI) (formerly NCCLS) (14).An initial set of 79 clinically significant isolates of CoNS from 79 individual patients attending the Rouen University Hospital between January 1999 and April 2001 was studied. Strains were identified to the species level with the ID32Staph system (bioMérieux, Marcy l'Etoile, France) and by a gap gene PCR-restriction fragment length polymorphism assay (24). This set reflected the current epidemiology of CoNS (11), with Staphylococcus epidermidis as a very dominant species (n ϭ 66; 84% of the isolates) and with some less frequently encountered species, i.e., S. hominis (n ϭ 4), S. capitis (n ϭ 3), S. lugdunensis