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Inhibition of Erythromycin and Erythromycin-Induced Resistance among Staphylococcus aureus Clinical Isolates

Aya A Mahfouz1,2, Heba S Said1, Sherin M Elfeky3

  • 1Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt.

Antibiotics (Basel, Switzerland)
|March 29, 2023
PubMed

Insights

Antibiotic resistance in Staphylococcus aureus is rising. This study found that doxorubicin, neomycin, and omeprazole can reduce erythromycin resistance, while other compounds may reverse clindamycin resistance.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Pharmacology

Background:

  • Increasing incidence of erythromycin resistance and erythromycin-induced clindamycin resistance in Staphylococcus aureus poses a significant clinical challenge.
  • Patients with inducible resistance phenotypes may experience treatment failure with clindamycin therapy.

Purpose of the Study:

  • To determine the prevalence of erythromycin resistance and erythromycin-induced clindamycin resistance in Staphylococcus aureus isolates.
  • To identify potential therapeutic agents that can inhibit or reverse these resistance mechanisms.

Main Methods:

  • Phenotypic detection of macrolide-lincosamide-streptogramin B (MLSB) resistance using D-test.
  • Identification of MLSB-resistance genes via PCR.
  • Screening of various compounds for their inhibitory effects on erythromycin and inducible clindamycin resistance using broth microdilution and checkerboard assays, followed by docking analysis.

Main Results:

  • Out of 99 clinical isolates, 91 were identified as Staphylococcus aureus.
  • Prevalence rates were: constitutive MLSB (39.6%), inducible MLSB (14.3%), and macrolide-streptogramin (MS) (2.2%).
  • Specific resistance genes (ermC, ermA, ermB, msrA, msrB, lnuA, mphC) were detected at varying frequencies. Doxorubicin, neomycin, and omeprazole significantly reduced erythromycin resistance. Quinine, ketoprofen, and fosfomycin reversed erythromycin/clindamycin-induced resistance.

Conclusions:

  • The study underscores the importance of managing antibiotic resistance and addressing clindamycin treatment failures.
  • Doxorubicin, neomycin, omeprazole, quinine, ketoprofen, and fosfomycin show potential as inhibitors against erythromycin and inducible clindamycin resistance in Staphylococcus aureus.
Keywords:
MLSBerythromycin resistanceinducible clindamycin resistancepotential inhibitors

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