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Related Experiment Videos

Aminoglycoside-resistant enterococci.

M J Basker, B Slocombe, R Sutherland

    Journal of Clinical Pathology
    |April 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Amoxycillin shows greater activity than benzylpenicillin against Streptococcus faecalis. Many strains exhibit resistance to certain aminoglycosides, impacting combination therapy effectiveness.

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    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Streptococcus faecalis (now Enterococcus faecalis) is a significant cause of hospital-acquired infections.
    • Antibiotic resistance in enterococci is a growing clinical concern.
    • Understanding antimicrobial susceptibility patterns is crucial for effective treatment.

    Purpose of the Study:

    • To assess the in vitro sensitivity of recent clinical isolates of Streptococcus faecalis to various penicillins and aminoglycosides.
    • To investigate the synergistic bactericidal activity of amoxycillin combined with aminoglycosides.
    • To identify potential resistance mechanisms and their impact on combination therapy.

    Main Methods:

    • Testing thirty-four clinical isolates of Streptococcus faecalis for antimicrobial susceptibility.

    Related Experiment Videos

  • Evaluating sensitivity to amoxycillin, benzylpenicillin, streptomycin, kanamycin, gentamicin, tobramycin, and amikacin.
  • Assessing bactericidal synergy of amoxycillin/aminoglycoside combinations.

    • Main Results:

    • Amoxycillin demonstrated 2- to 4-fold greater activity than benzylpenicillin; all strains were susceptible to low penicillin concentrations.
    • A significant proportion of strains showed resistance to streptomycin and kanamycin (23%), but remained sensitive to gentamicin, tobramycin, and amikacin.
    • Two strains, previously treated with topical gentamicin, exhibited relative resistance to gentamicin and reduced sensitivity to other aminoglycosides.
    • Amoxycillin/aminoglycoside combinations showed bactericidal synergy, contingent on strain susceptibility to the aminoglycoside.
    • Synergy was not observed with amoxycillin/amikacin against kanamycin-resistant strains, despite amikacin sensitivity in growth inhibition tests.
    • Gentamicin-resistant strains displayed variable responses to amoxycillin/aminoglycoside combinations.

    Conclusions:

    • Penicillins are highly active against Streptococcus faecalis, with amoxycillin being more potent than benzylpenicillin.
    • Emerging aminoglycoside resistance, particularly high-level resistance to streptomycin and kanamycin, is a concern.
    • Previous gentamicin therapy may select for strains with reduced aminoglycoside susceptibility.
    • Amoxycillin/aminoglycoside combination therapy can be synergistic, but resistance patterns must be considered for optimal outcomes.
    • Further investigation into resistance mechanisms and tailored combination strategies is warranted.