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Evaluation of the in-vitro synergistic potential of vancomycin combined with other antimicrobial agents against methicillin-resistant <i>Staphylococcus aureus</i> isolates

Article

Last updated: 04 Jan 2025

Subjects

-

Tags

Antimicrobial resistance

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a major public health problem, causing a wide range of infections including bacteremia. Infections caused by MRSA are associated with significant morbidity, mortality, and costs. The present study aimed to determine the frequency of MRSA isolates among bacteremic patients, to determine their antimicrobial susceptibility patterns and to evaluate the in-vitro synergy combinations of vancomycin plus imipenem, cefepime, cefazoline and piperacillin-tazobactam against these isolates. Methods: Fifty confirmed MRSA strains isolated from blood cultures constituted the material of this study. The BD Phoenix was used to determine the susceptibility of these isolates to different antimicrobials. The Two-agent Broth Microdilution checkerboard test was used to evaluate the effect of combinations of two antimicrobial agents on the studied isolates. Results: In the current study the prevalence of MRSA among bacteremic patients was 15.68%, resistance rate was as follow: Gentamicin (80%), erythromycin (68%), ciprofloxacin (64%), norfloxacin (52%), moxifloxacin (36%), trimethoprim-sulfamethoxazole (46%), doxycycline (38%), rifampin (34%), clindamycin (24%), chloramphenicol (8%), linezolid (6%), teicoplanin (2%). All isolates were fully susceptible to daptomycin and vancomycin. Synergy was seen in varying proportions of the MRSA isolates when vancomycin was combined with imipenem, piperacillin-tazobactam, cefepime and cefazolin that was 76%, 66%, 54% and 52% respectively. No antagonism was observed. The mean FIC indices for combination of Vancomycin with Imipenem were significantly inversely correlated with the vancomycin MICs of the isolates using linear regression analysis. Conclusions: The synergistic activity of vancomycin in combination with β- lactam antibiotics offers new insights in treatment options of serious MRSA infections.

DOI

10.21608/mid.2022.158151.1373

Keywords

MRSA, In-vitro synergism, Antimicrobial resistance

Authors

First Name

Hala

Last Name

El metwally

MiddleName

Abd ElRaouf

Affiliation

Medical microbiology and immunology, faculty of medicine, Alexandria university

Email

halabdelraouf@hotmail.com

City

-

Orcid

-

First Name

Nagah

Last Name

Hamed

MiddleName

-

Affiliation

Kafr Eladwar fever hospital, El Beheira governorate

Email

nagahhamed@hotmail.com

City

-

Orcid

-

First Name

Shams

Last Name

Arafa

MiddleName

-

Affiliation

Medical microbiology and immunology, Faculty of medicine, Alexandria university

Email

shams.arafa@alexmed.edu.eg

City

-

Orcid

0000-0002-9683-4530

Volume

3

Article Issue

4

Related Issue

37291

Issue Date

2022-10-01

Receive Date

2022-08-23

Publish Date

2022-10-01

Page Start

920

Page End

932

Print ISSN

2682-4132

Online ISSN

2682-4140

Link

https://mid.journals.ekb.eg/article_258972.html

Detail API

https://mid.journals.ekb.eg/service?article_code=258972

Order

18

Type

Original Article

Type Code

1,157

Publication Type

Journal

Publication Title

Microbes and Infectious Diseases

Publication Link

https://mid.journals.ekb.eg/

MainTitle

Evaluation of the in-vitro synergistic potential of vancomycin combined with other antimicrobial agents against methicillin-resistant <i>Staphylococcus aureus</i> isolates

Details

Type

Article

Created At

22 Jan 2023