Abstract
Background:Multi-drug resistant methicillin resistant Staphylococcus aureus (MRSA) strains that have been isolated frequently worldwide have difficulties in the treatment and therefore alternative choices for the treatment of the infections are required. The aim of the study was to evaluate the interaction of various antimicrobials in combination with vancomycin against MRSA.Methods:Twenty five clinical MRSA strains isolated in 2016 were included in the study. The interaction between vancomycin and new generation/conventional antimicrobials against MRSA strains was analyzed by E-test.Results:All of the strains tested was found to be susceptible to vancomycin, telavancin, dalbavancin, ceptobiprole, daptomycin, linezolid, quinupristin-dalfopristin, trimethoprim-sulfamethoxazole, rifampicin and tigecycline. The susceptibility rates of the isolates were found to be high, with the lowest rate (48%) against azithromycin. According to the fractional inhibitory concentration index results, synergistic interaction with vancomycin was determined with trimethoprim-sulfamethoxazole, azithromycin, linezolid, minocycline, dalbavancin, clindamycin in five, three, two, two, one, one and one strain(s), respectively. Additionally, all combinations studied showed additive interaction at high rates.Conclusions:The results of the study indicate that the use of vancomycin in combination with conventional and new generation antibiotics is promising.
Highlights
Multiple antibiotic resistant Gram-positive pathogens have been causing severe problems in the treatment since 1980s.1,2 Methicillinresistant Staphylococcus aureus (MRSA) remains an important cause of serious infections, among hospitalized patients, and it has recently been observed in an increasing trend in community settings.[3,4] Vancomycin is often recommended as the first-choice antibiotic in the treatment of methicillin resistant Staphylococcus aureus (MRSA) infections
All of the strains were found to be sensitive to vancomycin, telavancin, dalbavancin, ceftobiprole, daptomycin, linezolid, quinuprustin/dalfopristin, trimetoprim/ sulfametoxazole, rifampicin, and tigecycline
The results show that both antimicrobials have excellent activities against MRSA strains
Summary
Multiple antibiotic resistant Gram-positive pathogens have been causing severe problems in the treatment since 1980s.1,2 Methicillinresistant Staphylococcus aureus (MRSA) remains an important cause of serious infections, among hospitalized patients, and it has recently been observed in an increasing trend in community settings.[3,4] Vancomycin is often recommended as the first-choice antibiotic in the treatment of MRSA infections. Methicillinresistant Staphylococcus aureus (MRSA) remains an important cause of serious infections, among hospitalized patients, and it has recently been observed in an increasing trend in community settings.[3,4] Vancomycin is often recommended as the first-choice antibiotic in the treatment of MRSA infections. The aim of the study was to evaluate the interaction of various antimicrobials in combination with vancomycin against MRSA. The interaction between vancomycin and new generation/conventional antimicrobials against MRSA strains was analyzed by E-test. According to the fractional inhibitory concentration index results, synergistic interaction with vancomycin was determined with trimethoprim-sulfamethoxazole, azithromycin, linezolid, minocycline, dalbavancin, clindamycin in five, three, two, two, one, one and one strain(s), respectively. Conclusions: The results of the study indicate that the use of vancomycin in combination with conventional and new generation antibiotics is promising
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