In vitro susceptibility of<i>Staphylococcus aureus</i>towards amoxycillin‐clavulanic acid, penicillin‐clavulanic acid, dicloxacillin and cefuroxime

Skov, Robert; Frimodt‐Møller, Niels; Espersen, Frank

doi:10.1034/j.1600-0463.2002.11007807.x

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…The relative stabilities of cefuroxime have been previously described, although using few Bla-positive strains of unknown type (18). Cefuroxime has shown similar efficacies to methicillin and cefazolin in the treatment of experimental MSSA endocarditis (19) and appeared to have greater efficacy than cefazolin in an endocarditis model using an MSSA strain with high-level production of type A Bla (20).…”

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Determination of an Inoculum Effect with Various Cephalosporins among Clinical Isolates of Methicillin-Susceptible Staphylococcus aureus

Nannini

Stryjewski

Singh

et al. 2010

Antimicrob Agents Chemother

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Using 98 clinical methicillin-susceptible Staphylococcus aureus isolates of known ␤-lactamase (Bla) type, we found a pronounced inoculum effect for cephalexin (mostly Bla type A and C strains), a mild inoculum effect for cephalothin (especially types B and C), and no inoculum effects for ceftriaxone and cefuroxime. Ceftobiprole showed the lowest MICs at a high inoculum but with a slight increase for Bla-positive versus Bla-negative strains. Since a potential therapeutic effect associated with a cephalosporin inoculum effect has been described, further studies are warranted.Strains of methicillin-susceptible Staphylococcus aureus (MSSA) are still responsible for the majority of severe staphylococcal infections, as shown in a recent international study in which 85.2% of S. aureus strains producing native valve endocarditis were susceptible to methicillin (11). About 90% of the MSSA isolates produce one of four variants of ␤-lactamase(s) (Bla) (16) identified as type A, B, C, or D (9, 13, 22). Each of these staphylococcal Bla types has a specific substrate profile (21). These severe MSSA infections are often treated with cephalosporins, and even though cephalosporins are regarded as generally stable in the presence of staphylococcal Bla, it was shown early on that when tested at higher inocula, some cephalosporins were hydrolyzed by certain types of Bla (inoculum effect) (10). It was not until the 1990s, when the kinetics of hydrolysis among the four types of staphylococcal Bla were reported, that the classification of cephalosporins as Bla stable or labile was considered an oversimplification of the cephalosporin-Bla interaction (23). However, the actual effect of each type of staphylococcal Bla on the in vitro activity of different cephalosporins, measured by the presence of an inoculum effect, has not been clearly defined. Strains producing a large amount of the Bla enzyme and/or showing high MICs when a large inoculum is used have been associated with clinical failures in patients suffering high-inoculum staphylococcal disease (e.g., cefazolin in the treatment of endocarditis caused by MSSA producing type A Bla) (2, 4, 12, 15). We have recently shown that about 20% of MSSA clinical strains displayed an elevated cefazolin MIC (Ն16 g/ml) when tested at a high inoculum (13). Here, using high-inoculum MIC determinations, we determined the presence of an inoculum effect for several cephalosporins by using a set of clinical MSSA isolates previously classified by the type of Bla produced (13).Ninety-eight clinical MSSA strains that have been previously reported were included in this analysis, as follows: 25 type A, 15 type B, 45 type C, and 0 type D Bla strains and 13 blaZnegative strains (13). S. aureus strain TX0117, a high-level producer of type A Bla (12); S. aureus ATCC 29213, known to produce small amounts of type A Bla (9); and S. aureus ATCC 25923, a Bla-negative strain, were used as controls. MICs were determined by the broth microdilution method, using the Clinical and Laboratory Standards Institute (CLSI) g...

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confidence: 99%

Determination of an Inoculum Effect with Various Cephalosporins among Clinical Isolates of Methicillin-Susceptible Staphylococcus aureus

Nannini

Stryjewski

Singh

et al. 2010

Antimicrob Agents Chemother

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“…36 Recently, scientists observed that clavulanic acid was highly effective in protecting against beta-lactamase degradation of both penicillin and amoxicillin and found that both cefuroxime and dicloxacillin were highly stable against staphylococcal beta-lactamase degradation. 37 However, these novel approaches are still under development and long-term effects have not been studied.…”

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Management of acute bacterial skin and skin structure infections in India: are we equipped to meet the challenges of the growing menace of methicillin-resistant Staphylococcus aureus?

et al. 2020

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Staphylococcus aureus (S. aureus) is a Gram-positive facultative anaerobic bacterium that colonizes the skin and nasal passages of humans. The incidence of invasive S. aureus infections has increased over the past decades and is associated with poor outcomes and high mortality rates. S. aureus is responsible for almost one-third of acute bacterial skin and skin structure infections with methicillin-resistant Staphylococcus aureus (MRSA) accounting for a large proportion of these. The S. aureus strains prevalent inIndia are more aggressive and there are recent reports of the emergence of the more virulent multidrug resistant lineages ST2371 and ST8. Management of these infections is complicated by the fact that antimicrobial stewardship is non-existent, the choice of treatment is often empirical and available treatment options are limited due to a high prevalence of resistance strains. Currently available anti-MRSA agents include vancomycin, teicoplanin, linezolid, daptomycin, tigecycline, and clindamycin. However, the emergence of resistant strains and several undesirable features related to the safety and tolerability of these agents have limited the options available for the management of MRSA infections. A newer, safe and efficacious antibiotic is thus an unmet need for the management of MRSA in patients with acute bacterial skin and skin structure infections. In this review we explore the current and future trends in the management of acute bacterial skin and skin structure infections highlighting the challenges in their management in India, and current progress in the development of some novel drugs for the management of MRSA infections.

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Growing Antibiotic Resistance in Fatal Cases of Staphylococcal Pneumonia in the Elderly

Yayan

Rasche

2015

Advances in Experimental Medicine and Biology

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Older people are often especially susceptible to pneumonia and bacteria may develop resistance to antibiotics quicker in the elderly, whose immune systems gradually diminish. This study analyses, retrospectively, resistance to antibiotics in high-risk elderly patients with fatal pneumonia. Records of all patients aged over 65 who did not survive a bout with pneumonia were gathered from the records of the Department of Pneumology of HELIOS Clinic in Wuppertal, Germany from the period of 2004-2014. Susceptibility testing was executed for the study population, whose pneumonia was triggered by various kinds of bacteria. We detected 936 pneumonia patients of the overall mean age of 68.0 ± 13.6 years, with the following pneumonia types: 461 (49.3 %) community-acquired, 354 (37.8 %) nosocomial-acquired, and 121 (12.9 %) aspiration pneumonia. There were 631 (67.4 %) males and 305 (32.6 %) females there. We identified 672 (71.8 %) patients who had a high risk for pneumonia, especially staphylococcal pneumonia (p < 0.0001). The elderly patients had a higher risk of dying from pneumonia (2.9 odds ratio, 95 % confidence interval 1.8-4.6; p < 0.0001); of the 185 pneumonia-related deaths, 163 (88.1 %) were in the elderly. In those with fatal staphylococcal pneumonia, a high antibiotic resistance rate was found for piperacillin-tazobactam (p = 0.044), cefuroxime (p = 0.026), cefazolin (p = 0.043), levofloxacin (p = 0.018), erythromycin (p = 0.004), and clindamycin (p = 0.025). We conclude that elderly patients with staphylococcal pneumonia show resistance to common antibiotics. However, no significant antibiotic resistance could be ascribed for other types of pneumonia in these patients.

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In vitro susceptibility ofStaphylococcus aureustowards amoxycillin‐clavulanic acid, penicillin‐clavulanic acid, dicloxacillin and cefuroxime

Cited by 4 publications

References 17 publications

Determination of an Inoculum Effect with Various Cephalosporins among Clinical Isolates of Methicillin-Susceptible Staphylococcus aureus

Determination of an Inoculum Effect with Various Cephalosporins among Clinical Isolates of Methicillin-Susceptible Staphylococcus aureus

Management of acute bacterial skin and skin structure infections in India: are we equipped to meet the challenges of the growing menace of methicillin-resistant Staphylococcus aureus?

Growing Antibiotic Resistance in Fatal Cases of Staphylococcal Pneumonia in the Elderly

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