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PubMed2006

Antimicrobial susceptibility of Staphylococcus aureus and Staphylococcus epidermidis biofilms isolated from infected total hip arthroplasty cases.

BACKGROUND: It is difficult to treat implant-related infections because bacteria form biofilms on implants. Biofilms protect the organisms from the host's immune system and prevent penetration of antimicrobial agents. We investigated the susceptibility of six strains isolated from infected total hip arthroplasty (THA) cases to six antimicrobial agents. METHODS: Six Staphylococcus aureus and S. epidermidis strains isolated from infected THA cases and S. aureus ACTT 25923, positive strains of biofilms, were used in this study. Biofilms were developed on 96-well titer plates. After 7 days the nutrient solution was aspirated, and wells were rinsed three times with sterile water. A series of doubling dilutions of each antimicrobial agent (16, 32, 64, 128, 256, 512, and 1024 microg/ml) in trypticase soy broth were added to the wells. The plates were incubated at 37 degrees C. After 24 h, the contents were aspirated and wells were rinsed three times with sterile water. The surfaces of wells were vigorously scraped with a sterile swab and applied to sheep blood agar plates at 37 degrees C in an aerobic chamber for 24 h. The minimum bactericidal concentrations (MBCs) were determined as the lowest concentration of antibiotic resulting in 100% reduction of viable cells compared to the antibiotic-free control. Biofilms were produced on stainless steel washers, and the time-course changes were observed by scanning electron microscopy (SEM). RESULTS: Planktonic bacteria were sensitive to the antimicrobial agents, but biofilm bacteria were markedly resistant. SEM revealed that biofilms grew larger with time. CONCLUSIONS: The MBCs of antimicrobial agents for biofilms bacteria were higher than those of planktonic bacteria. Therefore, it is suggested that implant-related infection is difficult to treat with antimicrobial agents alone.

Adult↗
PubMed2003

Comparison of the bactericidal activity of moxifloxacin and levofloxacin against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Klebsiella pneumoniae.

In addition to MIC and MBC tests in this study the serum bactericidal activity of 3.1 microg/ml of moxifloxacin or 5.2 microg/ml of levofloxacin was determined against ten susceptible strains of S. aureus, S. epidermidis, E. coli and K. pneumoniae. Moxifloxacin achieved markedly better activity against S. aureus and S. epidermidis as compared to levofloxacin. Activity of moxifloxacin against E. coli and K. pneumoniae was excellent but not superior to levofloxacin. In conclusion both fluorquinolones are highly effective against E. coli and K. pneumoniae, moxifloxacin being superior with respect to gram-positives like S. aureus and S. epidermidis.

Anti-Bacterial Agents↗
PubMed2004

Effect of hospitalization and antimicrobial therapy on antimicrobial resistance of colonizing Staphylococcus epidermidis.

Endogenous infections with multi-resistant S. epidermidis are among the leading causes of nosocomial infections. The effect of hospitalization and antimicrobial therapy on antimicrobial resistance of colonizing staphylococci was determined from swabs of the nose, hand, axilla and groin from 157 patients on one day. Hospitalization for >72 hours, compared with <72 hours, was associated with a higher percentage of isolates resistant to oxacillin (56% versus 19%), gentamicin (40% versus 15%), trimethoprim (36% versus 17%), clindamycin (56% versus 17%), and fusidic acid (20% versus 4%; p < 0.01 for all), but not to rifampicin (6% versus 1%) or fosfomycin (43% versus 34%, p > 0.05 for both). Concurrent antimicrobial therapy resulted in increased resistance to oxacillin (61% versus 28%), gentamicin (43% versus 20%), and clindamycin (60% versus 26%; p < 0.01 for all), but not to trimethoprim (39% versus 23%), fusidic acid (19% versus 9%), rifampicin (6% versus 3%), or fosfomycin (46% versus 38%, p > 0.05 for all). The increase in resistant isolates was not independent, since hospitalization and antimicrobial therapy were correlated (p < 0.001). After adjustment for potential risk factors such as diabetes mellitus, central venous catheters, and hemodialysis, the odds ratio for oxacillin resistance was 2.8-3.6. None of the risk factors showed statistically significant results, except for the presence of neoplastic disease, which had a significant interaction (P=0.035). The within-subgroup odds ratios for patients with and without neoplasm were 4.2 (95% CI, 2.3-5.7) and 2.1 (95% CI, 0.78-3.12), respectively. These results show that hospitalization for more than three days, with or without antimicrobial therapy, and the presence of neoplastic disease are associated with increased antimicrobial resistance in colonizing S. epidermidis.

Age Distribution↗
PubMed2000

Efficacy of rifampin-levofloxacin as a prophylactic agent in preventing Staphylococcus epidermidis graft infection.

OBJECTIVES: To investigate the efficacy of levofloxacin in the prevention of vascular prosthetic graft infection in a rat model. METHODS: Graft infections were established in the subcutaneous tissue of 225 male Wistar rats by implantation of Dacron prostheses followed by topical inoculation with methicillin-susceptible and methicillin-resistant S. epidermidis. The study included a group without contamination, two contaminated groups without prophylaxis, two contaminated groups with intraperitoneal levofloxacin prophylaxis, two contaminated groups with intraperitoneal cefazolin prophylaxis, two contaminated groups with intraperitoneal teicoplanin prophylaxis and six contaminated groups with rifampin-soaked graft and intraperitoneal levofloxacin, cefazolin or teicoplanin prophylaxis. The grafts were removed after 7 days and evaluated by quantitative culture. RESULTS: The efficacy of levofloxacin against the methicillin-susceptible strain was not different to that of cefazolin or teicoplanin. Levofloxacin showed slight less efficacy than teicoplanin against the methicillin-resistant strain. The combination levofloxacin-rifampin demonstrated to be similarly effective to the combination rifampin-teicoplanin and more effective than the combination rifampin-cefazolin against both strains. CONCLUSIONS: Rifampin-levofloxacin combination seems useful for the prevention of late-appearing vascular graft infections caused by S. epidermidis.

Animals↗
PubMed2004

Staphylococcus aureus, but not Staphylococcus epidermidis, modulates the oxidative response and induces apoptosis in human neutrophils.

S. epidermidis is the most common isolate in foreign body infections. The aim of this study was to understand why S. epidermidis causes silent biomaterial infections. In view of the divergent inflammatory responses S. epidermidis and S. aureus cause in patients, we analyzed how they differ when interacting with human neutrophils. Neutrophils interacting with S. epidermidis strains isolated either from granulation tissue covering infected hip prostheses or from normal skin flora were tested by measuring the oxidative response as chemiluminescence and apoptosis as annexin V binding. Different S. aureus strains were tested in parallel. All S. epidermidis tested were unable to modulate the oxidative reaction in response to formyl-methionyl-leucyl-phenylalanine (fMLP) and did not provoke, but rather inhibited, apoptosis. In contrast, some S. aureus strains enhanced the oxidative reaction, and this priming capacity was linked to p38-mitogen-activated-protein-kinase (p38-MAPK) activation and induction of apoptosis. Our results may explain why S. epidermidis is a weak inducer of inflammation compared to S. aureus, and therefore responsible for the indolent and chronic course of S. epidermidis biomaterial infections.

Annexin A5↗
PubMed1993

Vancomycin therapy of experimental peritoneal catheter-associated infection (Staphylococcus epidermidis) in a mouse model.

Catheter-related sepsis, principally with S. epidermidis, remains a main complication of continuous ambulatory peritoneal dialysis (CAPD). A possible reason for the antibiotic resistance often displayed by these infections is the presence of bacteria growing in a protective biofilm on the catheter surface. We developed a reproducible stable model of experimental peritoneal catheter-associated infection with S. epidermidis in the mouse and used this model to examine the therapeutic efficacy of vancomycin. The response to vancomycin treatment given daily (15 mg/kg body weight) for periods from 1-14 days, relating the proportion of successful outcome (sterilization of implant infection) over time, was typical of an S-shaped biological response curve. These results extend our previous observations in vitro of the activity of vancomycin against S. epidermidis biofilm preparations and serve as a rational basis for the experimental evaluation of synergy and antagonism in the treatment of implant-associated infection.

Animals↗
PubMedDate not supplied

[The role of Staphylococcus epidermidis persistence factors in the infectious process].

The species composition of microflora was determined and the etiological role of S. epidermidis was shown in some purulent inflammatory diseases (maxillary sinusitis, urethritis). The role of the complex of S. epidermidis persistence factors in the chronization of the infectious process and the formation of the resident carrier state was established.

Acute Disease↗
PubMed2000

Chromosomal rearrangements affecting biofilm production and antibiotic resistance in a Staphylococcus epidermidis strain causing shunt-associated ventriculitis.

During two clinical courses of shunt-associated meningitis in a 3-month-old child, five multiresistant S. epidermidis isolates were obtained and analyzed with regard to biofilm production and antibiotic susceptibility. Three S. epidermidis strains, which were initially isolated from the cerebrospinal fluid, produced biofilms on polystyrene tissue culture plates. Following antibiotic treatment and subsequent exchange of the shunt system, sterilization of the CSF was achieved. However, after three weeks a relapse of the infection occurred. The two S. epidermidis isolates obtained now were biofilm negative, but showed an identical resistance pattern as those from the previous infection, except that resistance to rifampicin and increased mininal inhibitory concentrations of aminoglycoside antibiotics had emerged. DNA fingerprinting by PFGE indicated the clonal origin of all isolates. However, some DNA rearrangements and differences in the IS256-specific hybridization patterns could be identified in the isolates from the second infection period that led to altered biofilm formation and increased expression of aminoglycoside resistance traits. The data evidence that variation of biofilm expression occurs in vivo during an infection and highlight the extraordinary genome flexibility of pathogenic S. epidermidis.

Anti-Bacterial Agents↗
PubMed1998

[Isolation and drug susceptibility of Staphylococcus epidermidis from respiratory tract].

OBJECTIVE: In order to realize the significance on the isolation and drug susceptibility of S. epidermidis from patients with lower respiratory tract infections. METHOD: (1) Qualified sputum specimens from inpatients in general wards with lower respiratory tract infections were cultured for bacteria and identification between 1990 and 1996. (2) Drug susceptibility of commonly used antibiotics against isolated S. epidermidis strains was determined by K-B methods or agar dilution method. RESULT: (1) Two thousand and six hundred sixty strains of various kinds of bacteria were isolated from 6228 sputum specimens, 257 strains (9.66%) of which were S. epidermidis (ranking the forth). The isolating rate of S. epidermidis was 4.13%. (2) By determining the drug susceptibility of S. epidermidis to 21 commonly used antibiotics, it was found that this bacterium was resistant to all the agents except vancomycin in different levels, and the resistant rate ranged from 15.2% to 98.1%, of which many strains showed multidrug resistance. Vancomycin, imepinem, cefocefin and cefoperazone were relatively sensitive agents tested, the resistant rates being 0, 17.1%, 18.7% and 30.0%, respectively. The resistant rates of all other agents were higher than 48.5%, some of which higher than 80%. The resistant rate of penicillin G was nearly 100%. CONCLUSION: Attention should be paid to the high isolating rate of S. epidermidis in the respiratory tract infections and the high drug resistance in some strains, and the role of this bacterium in the lower respiratory tract infections needs to be studied.

Anti-Bacterial Agents↗
PubMedDate not supplied

In vitro activity of lomefloxacin against multiply resistant Pseudomonas aeruginosa, Enterobacter cloacae, and Staphylococcus epidermidis.

Lomefloxacin is a promising new difluorinated quinolone with good antimicrobial activity and favorable pharmacokinetic properties. The in vitro activity of lomefloxacin was compared to other quinolones, expanded spectrum beta-lactams, and gentamicin. The lomefloxacin MIC90 against multiply resistant strains of P. aeruginosa was 4 mcg/ml, comparable to norfloxacin and ofloxacin. Lomefloxacin was also active against methicillin-resistant S. epidermidis and JK corynebacteria. The role of lomefloxacin in the treatment of infections caused by multiresistant organisms remains to be determined in clinical trials.

Anti-Infective Agents↗