The Potential Role of Sulbactam and Cephalosporins Plus Daptomycin Against Daptomycin-Nonsusceptible VISA and H-VISA Isolates: An In Vitro Study

doi:10.3390/antibiotics8040184

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Title:	The Potential Role of Sulbactam and Cephalosporins Plus Daptomycin Against Daptomycin-Nonsusceptible VISA and H-VISA Isolates: An In Vitro Study
Authors:	Lai, Chih-Cheng Chen, Chi-Chung Lu, Ying-Chen Tsuey-Pin Lin(林翠品) Chen, Hung-Jui Su, Bo-An Chao, Chien-Ming Chuang, Yin-Ching Hung-Jen Tang(湯宏仁)
Contributors:	Kaohsiung Vet Gen Hosp, Dept Internal Med, Tainan Branch Chi Mei Med Ctr, Dept Med Res Natl Chiayi Univ, Dept Food Sci Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Chi Mei Med Ctr, Dept Med Chi Mei Med Ctr, Dept Intens Care Med
Keywords:	vancomycin-intermediate resistant S aureus heterogeneous vancomycin-intermediate S aureus daptomycin cephalosporin sulbactam synergism test
Date:	2019-12
Issue Date:	2020-07-29 13:54:22 (UTC+8)
Publisher:	MDPI
Abstract:	This study assesses the synergistic effect of the combination of cephalosporins and sulbactam with daptomycin against daptomycin-nonsusceptible, vancomycin-intermediate resistant Staphylococcus aureus (VISA) or heterogeneous vancomycin-intermediate S. aureus (h-VISA) isolates. The in vitro activity of daptomycin against daptomycin-nonsusceptible VISA/h-VISA isolates after adding cephalosporins with or without sulbactam was evaluated. The MIC of daptomycin against the VISA/h-VISA isolates was reduced after adding cephalosporins to daptomycin. Except for one VISA and two h-VISA isolates, the other VISA/h-VISA isolates became daptomycin-susceptible (MICs <= 1 mg/L). After adding sulbactam to each daptomycin/cephalosporin combination, the MIC of daptomycin against the VISA/h-VISA isolates decreased for 5 (33.3%), 6 (40.0%), 6 (40.0%), and 6 (40.0%) isolates with the cefazolin, cefmetazole, cefotaxime, and cefepime combinations, respectively. Synergism using the checkerboard method was noted in 100% of cefazolin and cefotaxime combinations and 87% and 80% of cefmetazole and cefepime combinations for all the VISA and h-VISA isolates. With the addition of sulbactam, synergism was noted in 100% of cefazolin, cefmetazole, and cefotaxime combinations and 93% of the cefepime combinations for all the VISA and h-VISA isolates. Almost all the FICs for the three-drug combinations were lower than those for the two-drug combinations. Using time-killing methods, a synergistic effect against five h-VISA isolates was observed. A synergistic effect of daptomycin, sulbactam, and each cephalosporin was observed for all VISA isolates. In conclusion, the activity of daptomycin against daptomycin-nonsusceptible VISA/h-VISA isolates can be enhanced by adding cephalosporins, and partially further promoted by sulbactam.
Relation:	Antibiotics-Basel, v.8, n.4, 184
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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