Combination of cephalosporins with vancomycin or teicoplanin enhances antibacterial effect of glycopeptides against heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and VISA

doi:10.1038/srep41758

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Title:	Combination of cephalosporins with vancomycin or teicoplanin enhances antibacterial effect of glycopeptides against heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and VISA
Authors:	Lai, Chih-Cheng Chen, Chi-Chung Chuang, Yin-Ching Tang, Hung-Jen
Contributors:	Chi Mei Med Ctr, Dept Intens Care Med Chi Mei Med Ctr, Dept Med Res Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Chi Mei Med Ctr, Dept Med
Keywords:	Minimum Inhibitory Concentration Field Gel-Electrophoresis Treatment Outcomes Clinical-Outcomes In-Vitro Bacteremia Infections Strain Susceptibility Metaanalysis
Date:	2017-01-31
Issue Date:	2018-11-30 15:56:30 (UTC+8)
Publisher:	Nature Publishing Group
Abstract:	Eight heterogeneous vancomycin-intermediate S. aureus (h-VISA) and seven VISA clinical isolates confirmed by the population analysis profile/area under the curve ratio (PAP/AUC) were collected. We further performed the PAP/AUC, time-killing methods and MIC tests using vancomycin/teicoplanin alone or combination with susceptible breakpoint concentrations of cefazolin, cefmetazole, cefotaxime, and cefepime for these isolates. The PAP/AUC MIC curve shifted left after addition of cephalosporins with vancomycin or teicoplanin for both h-VISA and VISA isolates. With the combination of different cephalosporins with vancomycin or teicoplanin, the AUC/Mu3 AUC ratio decreased to <0.9 for the standard Mu3 isolate which are compatible with the definition of vancomycin susceptible S. aureus. These decreases ranged between 1.81-2.02 and 2.37-2.85-fold for h-VISA treated with cephalosporins and vancomycin or teicoplanin, and 2.05-4.59, and 2.93-4,89-fold for VISA treated with cephalosporins with vancomycin or teicoplanin. As measured by time-killing assays, the combinations of different cephalosporins with vancomycin concentrations at 1/2 and 1/4 MIC, exhibited a bactericidal and bacteriostatic effect in VISA. The mean fold of MIC decline for vancomycin base combinations ranged from 1.81-3.83 and 2.71-9.33 for h-VISA and VISA, respectively. Overall, this study demonstrated the enhanced antibacterial activity of vancomycin/teicoplanin after adding cephalosporins against clinical h-VISA/VISA isolates.
Relation:	Scientific Reports, v.7, pp.41758
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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