Related Experiment Videos
High-level resistance to aminoglycosides in enterococci; incidence and alternative active antibiotic combinations in
S Stefani1, G D'Amico, M L Mezzatesta
1Institute of Microbiology, University of Catania, Italy.
Abstract:
Enterococci with high-level resistance to aminoglycosides have been frequently isolated from clinical specimens in the last few years. It is well known that this resistance is linked to a lack of synergism of the beta-lactam/aminoglycoside combination used in the treatment of severe infections. Many authors have reported an increasing incidence of isolation of enterococci highly resistant to gentamicin. In order to overcome the failure of the currently used antimicrobial combinations, in this work the degree of activity of ciprofloxacin plus, respectively, the glycopeptides vancomycin and teicoplanin, and also the combination teicoplanin/netilmicin, was evaluated. The results obtained with ciprofloxacin/teicoplanin and teicoplanin/netilmicin combinations show a good percentage of synergy (about 70-80%) with respect to the combination of ciprofloxacin plus vancomycin. The results are encouraging also in the highly resistant strains.
Insights
High-level aminoglycoside resistance in enterococci reduces treatment effectiveness. Ciprofloxacin combined with teicoplanin or teicoplanin/netilmicin shows promising synergy against these resistant strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Increasing isolation of enterococci with high-level aminoglycoside resistance (HLAR) from clinical settings.
- HLAR in enterococci compromises the synergistic efficacy of traditional beta-lactam/aminoglycoside combinations for severe infections.
- Documented rise in gentamicin-resistant enterococci necessitates alternative therapeutic strategies.
Purpose of the Study:
- To evaluate the in vitro activity of novel antimicrobial combinations against resistant enterococci.
- To assess the synergistic potential of ciprofloxacin with vancomycin and teicoplanin.
- To determine the efficacy of teicoplanin/netilmicin combination therapy.
Main Methods:
- In vitro evaluation of antimicrobial activity and synergy.
- Testing combinations of ciprofloxacin/vancomycin, ciprofloxacin/teicoplanin, and teicoplanin/netilmicin.
- Focus on enterococcal strains exhibiting high-level resistance.
Main Results:
- Ciprofloxacin/teicoplanin and teicoplanin/netilmicin combinations demonstrated significant synergy, achieving 70-80% synergy rates.
- These combinations showed superior activity compared to ciprofloxacin/vancomycin.
- Encouraging results were observed even in highly resistant enterococcal strains.
Conclusions:
- Ciprofloxacin/teicoplanin and teicoplanin/netilmicin represent viable synergistic combinations for treating infections caused by aminoglycoside-resistant enterococci.
- These combinations offer a promising alternative to standard therapies failing due to resistance.
- Further investigation into these combinations is warranted for clinical application.