[Investigation of the Antibacterial Synergistic Activity of Fosfomycin-Teicoplanin Combination in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Various Clinical Sample].

IF 1.1 4区 医学 Q4 MICROBIOLOGY
Rümeysa Tuba Biçer, Tuncer Özekinci, Mücahide Esra Koçoğlu
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引用次数: 0

Abstract

The aim of this study was to investigate the detection of teicoplanin and fosfomycin antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) strains by different methods and to evaluate the antibacterial synergistic effect of teicoplanin-fosfomycin combination by using checkerboard assay and time kill curve assay. Forty-five MRSA strains isolated from clinical samples in routine medical microbiology laboratory of Göztepe Prof. Dr. Süleyman Yalçın City Hospital were included in the study. In the first stage of the combination study, minimum inhibitory concentrations (MIC) were investigated by broth microdilution for teicoplanin and by both broth microdilution and agar dilution methods for fosfomycin. The combination of teicoplanin and fosfomycin was tested by the checkerboard method in 45 MRSA strains and combination effect was determined according to fractional inhibitory concentration index (ΣFIC) calculation. The synergistic effect and bactericidal activity of antibiotic combination were studied against a randomly selected strain from the strains used in the study by using time-kill method for 24 hours. As a result of teicoplanin and fosfomycin antibiotic susceptibility studies, all isolates were found to be susceptible to both antibiotics according to the susceptibility breakpoints determined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A synergistic effect was found in 22 (49%), additive effect in 22 (49%) and indifferent effect in one (2%) of the 45 strains studied with the checkerboard method. The mean ΣFIC of 45 isolates was found to be 0.5. In the combination study of the antibiotics of the isolate that was studied with time-kill method, synergism was detected for 1/8 MIC concentrations at 12th hour and 24th hour and synergism at 1/4 MIC concentration at sixth hour, 12th hour and 24th hour. In the combination study of 1/4 MIC concentrations of antibiotics, bactericidal effect was detected at sixth hour and this effect was observed to disappear at 12th and 24th hours. High rate of synergistic antibacterial effect of teicoplanin-fosfomycin combination on MRSA isolates was demonstrated as a result of in vitro tests. Such studies conducted on antibiotic-resistant bacterial infections will provide clinicians different treatment options and will contribute to increasing survival. As a result of this study, provided that it is supported by future clinical studies, it can be stated that the teicoplanin-fosfomycin combination may be an effective treatment option in community and hospital-acquired infections caused by MRSA.

[福斯霉素-替考拉宁复方制剂对从不同临床样本中分离出的耐甲氧西林金黄色葡萄球菌菌株的抗菌协同作用研究]。
本研究旨在通过不同方法检测耐甲氧西林金黄色葡萄球菌(MRSA)菌株对替考拉宁和磷霉素的抗生素敏感性,并采用棋盘格检测法和时间杀伤曲线检测法评估替考拉宁-磷霉素复方制剂的抗菌增效作用。研究对象包括从 Göztepe Prof. Dr. Süleyman Yalçın 市医院常规医学微生物实验室的临床样本中分离出的 45 株 MRSA 菌株。在联合用药研究的第一阶段,采用肉汤微量稀释法检测了替考拉宁的最低抑菌浓度(MIC),采用肉汤微量稀释法和琼脂稀释法检测了磷霉素的最低抑菌浓度(MIC)。在 45 株 MRSA 菌株中采用棋盘格法检测了替考拉宁和磷霉素的复方制剂,并根据分数抑菌浓度指数(ΣFIC)计算确定了复方制剂的效果。采用时间杀灭法对研究中随机选取的菌株进行 24 小时杀菌,研究抗生素组合的协同效应和杀菌活性。根据欧洲抗菌药物敏感性测试委员会(EUCAST)确定的敏感性断点,对替考拉宁和磷霉素进行抗菌药物敏感性研究后发现,所有分离菌株都对这两种抗生素敏感。在使用棋盘格法研究的 45 株菌株中,有 22 株(49%)发现了协同效应,22 株(49%)发现了相加效应,1 株(2%)发现了无关效应。45 株分离菌株的平均ΣFIC 值为 0.5。在采用时间杀灭法对分离菌株进行的抗生素联合研究中,1/8 MIC 浓度的抗生素在第 12 小时和第 24 小时具有协同作用,1/4 MIC 浓度的抗生素在第 6 小时、第 12 小时和第 24 小时具有协同作用。在 1/4MIC浓度抗生素的联合研究中,第 6 小时检测到杀菌效果,第 12 和 24 小时这种效果消失。体外试验结果表明,替考拉宁-磷霉素复方制剂对 MRSA 分离物具有很高的协同抗菌效果。针对耐抗生素细菌感染开展的此类研究将为临床医生提供不同的治疗方案,并有助于提高存活率。通过这项研究,如果未来的临床研究支持这项研究,那么可以说替考拉宁-磷霉素复方制剂可能是治疗由 MRSA 引起的社区和医院感染的一种有效选择。
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来源期刊
Mikrobiyoloji bulteni
Mikrobiyoloji bulteni 生物-微生物学
CiteScore
1.60
自引率
20.00%
发文量
50
审稿时长
6-12 weeks
期刊介绍: Bulletin of Microbiology is the scientific official publication of Ankara Microbiology Society. It is published quarterly in January, April, July and October. The aim of Bulletin of Microbiology is to publish high quality scientific research articles on the subjects of medical and clinical microbiology. In addition, review articles, short communications and reports, case reports, editorials, letters to editor and other training-oriented scientific materials are also accepted. Publishing language is Turkish with a comprehensive English abstract. The editorial policy of the journal is based on independent, unbiased, and double-blinded peer-review. Specialists of medical and/or clinical microbiology, infectious disease and public health, and clinicians and researchers who are training and interesting with those subjects, are the target groups of Bulletin of Microbiology.
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