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PubMed2001

[Epidemiological profile of methicillin resistant Staphylococcus epidermidis with diminished sensitivity to teicoplanin and isolated from neutropenic patients at the National Center of Bone Marrow Transplantation in Tunis].

Fifty-seven methicillin resistant S. epidermidis with decreased susceptibility to teicoplanin were obtained from 14 neutropenic patients on a period of 11 months (19 February-31 December 1998) from essentially blood culture (30 strains) and ORL specimens (21 strains). The MIC90 of methicillin, gentamicin, ofloxacin and telcoplanin were respectively 1024, 1024, 512 and 32 mg/l. We applied pulsed field gel electrophoresis (PFGE) after Smal digestion to 21 isolates choosed between eight patients with multiple isolates (> two strains). For epidemiological control, a MetiR and TeicoR S. epidermidis isolated from blood culture taken from Caen CHU was include in study. Twenty-one isolates were separated by PFGE into eight group, from I to VIII. The control strain was classed in group IX. Group I include 14 strains which can be subdivised on three sub-types (differed by a single to three bands): seven strains have the pulsotype Ia and obtained respectively from five strains in transplantation unit and two strains in hematology unit. Two strains have the pulsotype Ib and isolated in the two units. Five strains have the pulsotype Ic and obtained also from transplantation unit (four strains) and hematology unit (one strain). All the other pulsotypes were identified in only one strain, frequently in association with the pulsotype I. Until recently, infections due to coagulase negative staphylococci have been regarded as endogenous in origin, these results with some pulsotype of S. epidermidis MetiR and TeicoR in the two separate units suggered a nosocomial origin, probably by medical staff transmission because no S. epidermidis TeicoR was isolated from environmental control during all the period.

Anti-Bacterial Agents↗
PubMedDate not supplied

Comparative rates of antibiotic action against Staphylococcus epidermidis biofilms.

The relative resistance of S. epidermidis implant-associated infections to antibiotic therapy has been ascribed to a protective function of the gluelike biofilm matrix produced by strains of S. epidermidis in contact with artificial surfaces. Using a standardized S. epidermidis biofilm assay we determined the periods of exposure required by various antibiotics to produce cessation of biofilm metabolic activity. Rifampin has the superior rate of action, producing substantial disruption of biofilm activity by 7 hr of exposure, but leading to replacement of the susceptible bacterial cells by rifampin-resistant mutant survivors. Other antibiotics required longer periods of exposure, in excess of 48 hr, but produced a bactericidal outcome. Combinations of antibiotics with rifampin produced strikingly divergent results. Cefazolin and vancomycin (cell wall active antibiotics) produced a bactericidal outcome at 16 hr of exposure, whereas gentamicin (aminoglycoside) neutralized the rapid action of rifampin with metabolic activity maintained at 48 hr. We confirmed the selectively protective function of the S. epidermidis biofilm with regard to antibiotic action. In vitro biofilm assays may be of value in guiding antibiotic therapy in S. epidermidis implant-associated infection.

Anti-Bacterial Agents↗
PubMed2005

The efficacy of intravitreal piperacillin/tazobactam in rabbits with experimental Staphylococcus epidermidis endophthalmitis: a comparison with vancomycin.

BACKGROUND: To investigate the efficacy of intravitreal piperacillin/tazobactam in rabbit eyes with experimental S. epidermidis endophthalmitis and to compare the outcomes with intravitreal vancomycin application. MATERIAL AND METHODS: Twenty-four New Zealand white albino rabbits were divided into three equal groups (n=8 in each), and the right eyes received 0.1-ml intravitreal injections of S. epidermidis suspension. The left eyes served as uninfected controls and were injected with 0.1 ml of saline solution. The right eyes of rabbits in group 1 were treated with intravitreal injection of 250 microg/0.1 ml piperacillin/tazobactam 24 h after intravitreal inoculation of S. epidermidis whereas group 2 eyes received intravitreal 1 mg/0.1 ml vancomycin. Group 3 eyes received no treatment and served as infected controls. Clinical examination of the eyes in each group was performed on the 1st, 3rd and 6th day after the inoculation of S. epidermidis. On the 6th day, 0.1-ml vitreous aspirates were obtained for microbiological analysis, and then the eyes were enucleated for histopathological evaluation. RESULTS: There were no statistically significant differences in mean clinical scores between the groups on the first day after S. epidermidis inoculation (p>0.05). On the 6th day, the mean clinical score of group 3 was significantly higher (p<0.001), but the mean clinical scores of groups 1 and 2 were similar (p=0.812). The mean logarithmic value of colony-forming units per milliliter of groups 1, 2 and 3 were 0.6+/-1.3, 0.5+/-1.5 and 5.3+/-0.7, respectively. Mean histopathological scores of the groups were 8.3+/-0.9, 7.5+/-1.3 and 15.6+/-1.2, respectively. Group 3 eyes had significantly more colony-forming units per milliliter and a higher histopathological score (for each, p<0.001), and there were no statistically significant differences in microbiological and histopathological scores between groups 1 and 2 (for each, p>0.05). CONCLUSION: Intravitreal application of 250 microg/0.1 ml piperacillin/tazobactam seems to be approximately equally effective with intravitreal 1 mg/0.1 vancomycin application in the treatment of experimental S. epidermidis endophthalmitis. Therefore, intravitreal piperacillin/tazobactam may be an alternative therapeutic option in the treatment of S. epidermidis endophthalmitis.

Animals↗
PubMed1993

The effect of peritoneal dialysis solutions on rifampin action against Staphylococcus epidermidis in the fluid and biofilm phases of growth.

Continuous ambulatory peritoneal dialysis (CAPD) catheter-associated infections can be resistant to conservative therapeutic measures despite the apparent susceptibility of the infecting bacterial strains to antibiotics. This chronicity of infection has been ascribed to the development of bacteria on the surfaces of catheter material within a protective polysaccharide shield or matrix. CAPD catheters are unique in being exposed to nonphysiological environments of dialysis fluids of varying physical properties and constitution. We determined that the rate of growth of S. epidermidis in the fluid phase in laboratory media or fresh dialysis solution was significantly influenced by pH. An acid milieu (pH 5) impaired growth compared to a neutral milieu (pH 7). Spent dialysis fluid, however, which had an approximately neutral pH, also impaired bacterial growth, the assumption being that this results from properties of spent fluid unrelated to pH. Using rifampin as the test antibiotic, we noted that its action on S. epidermidis was unaffected by pH or by the differing milieu of fresh and spent fluid. Bacterial growth was arrested regardless of the milieu. We further examined the potential of dialysis fluids to modify the interaction between rifampin and the matrix-enclosed bacteria of standardized S. epidermidis biofilms. We determined that the pH of the dialysis solution was a critical factor influencing the outcome of exposure of the biofilm to rifampin. An acid pH enhanced antibiotic activity, whereas a neutral pH was associated with antibiotic antagonism. These findings have implications in the management of S. epidermidis catheter-associated infections using rifampin.(ABSTRACT TRUNCATED AT 250 WORDS)

Dialysis Solutions↗