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Antibiotic susceptibility among Staphylococcus epidermidis isolated from prosthetic joint infections with special focus on rifampicin and variability of the rpoB gene
Örebro University Hospital.
Örebro University Hospital.
Linköping University, Department of Clinical and Experimental Medicine, Infectious Diseases. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
Örebro University Hospital.
2009 (English)In: CLINICAL MICROBIOLOGY AND INFECTION, ISSN 1198-743X, Vol. 15, no 3, 238-244 p.Article in journal (Refereed) Published
Abstract [en]

Staphylococcus epidermidis is the most important pathogen in infections related to implanted foreign materials, especially prosthetic joint infections (PJIs). The aim of this study was to investigate the antimicrobial activities of 16 antibiotics against S. epidermidis isolated from PJIs, with special focus on rifampicin and rpoB variability. Ninety-one per cent of the isolates were multiresistant (i.e. resistant to members of more than three classes of antibiotics). Thirty-nine per cent were resistant to rifampicin, associated with one or two single-nucleotide polymorphisms (SNPs) in rpoB. Using IsoSensitest agar with supplements, 61% were resistant to oxacillin, and using Mueller-Hinton II agar with supplement, 84% were resistant. Using the Etest, 58% were resistant to cefoxitin, and using the disk diffusion test, 91% were resistant. The mecA gene was detected in 85% of the isolates. Regarding recently available antibiotics, all isolates were susceptible to tigecycline and linezolid, and 97% were susceptible to daptomycin. In addition, two novel antibiotics, dalbavancin and ceftobiprole, were tested, although not yet available for routine use. The MIC50 and MIC90 values of these novel antibiotics were 0.032 and 0.047 mg/L and 0.5 and 1.5 mg/L, respectively. Among the other antibiotics, the rates of resistance varied between 0% (vancomycin) and 82% (trimethoprim-sulphamethoxazole). S. epidermidis strains causing PJIs often show multiresistance, including resistance to rifampicin, which is mainly caused by one or two SNPs. Some of the newer antimicrobial agents may provide alternatives for monotherapy or combination therapy with rifampicin. Detection of mecA is necessary before initiating treatment of infections due to S. epidermidis when it displays intermediate susceptibility to cefoxitin.

Place, publisher, year, edition, pages
2009. Vol. 15, no 3, 238-244 p.
Keyword [en]
Antibiotic susceptibility, resistance, prosthetic joint infections, rifampicin, rpoB, Staphylococcus epidermidis
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-17622DOI: 10.1111/j.1469-0691.2008.02663.xOAI: diva2:210920
Available from: 2009-04-07 Created: 2009-04-06 Last updated: 2013-12-11

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Nilsdotter-Augustinsson, Åsa
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Infectious DiseasesFaculty of Health SciencesDepartment of Infectious Diseases in Östergötland
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