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CC BY-NC-ND 4.0 · J Lab Physicians 2013; 5(02): 109-112
DOI: 10.4103/0974-2727.119862
Original Article

Fluoroquinolone Therapy in Staphylococcus aureus Infections: Where Do We Stand?

Neeta D Gade
Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
,
Mohiuddin S Qazi
Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
› Author Affiliations Source of Support: Nil.
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ABSTRACT

Aim: The study aimed to evaluate the utility of various commonly used fluoroquinolones against Staphylococcus aureus isolates.

Materials and Methods: A total of 250 isolates of S. aureus were studied from different clinical specimens like blood, pus, wound swabs, sputum, ear swabs, and body fluids between November 2009 and December 2011. All the isolates were tested for their susceptibility to fluoroquinolones and other antimicrobial agents by Kirby-Bauer disc diffusion method using criteria of standard zone of inhibition. Methicillin-resistant S. aureus (MRSA) detection was done by cefoxitin disk diffusion method. The MRSA isolates were tested for minimum inhibitory concentration (MIC) to vancomycin by E-test strips. All the MRSA strains were sent to National Staphylococcal Phage-typing Centre, Maulana Azad Medical College, New Delhi for phage typing.

Results: A total of 107 strains of S. aureus (42.8%) were detected as MRSA. Multidrug resistance was observed among the MRSA strains more commonly than among the MSSA stains. Among the fluoroquinolones, maximum resistance in MRSA was seen to ciprofloxacin (92.5%), followed by ofloxacin (80.4%). None of the S. aureus isolates showed resistance to vancomycin and linezolid. The MICs of vancomycin for the MRSA tested ranged from 0.5 to 2 μg/ml. Phage typing pattern of 107 MRSA isolates revealed that 37 (34.6%) MRSA isolates were nontypeable and 70 (65.4%) were typeable.

Conclusion: Ciprofloxacin can no longer be used in empirical therapy against MRSA infections. Use of other members of fluoroquinolone should be limited only to those strains that show laboratory confirmation of their susceptibility. Vancomycin remains the drug of choice to treat MRSA infections.

Keywords

Fluoroquinolones - methicillin-resistant S. aureus - phage typing - Staphylococcus aureus


Publication History

Article published online:
07 April 2020

© 2013.

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  • REFERENCES

  • 1 Chambers HF. The changing epidemiology of Staphylococcus aureus. Emerg Infect Dis 2001;7:178-82.
  • 2 Tiwari HK, Das AK, Sapkota D, Sivarajan K, Pahwa VK. Methicillin resistant Staphylococcus aureus: Prevalence and antibiogram in a tertiary care hospital in western Nepal. J Infect Dev Ctries 2009;3:681-4.
  • 3 Robert J, Bismuth R, Jarlier V. Decreased susceptibility to glycopeptides in methicillin-resistant Staphylococcus aureus: A 20 year study in a large French teaching hospital, 1983-2002. J Antimicrob Chemother 2006;57:506-10.
  • 4 Bal M, Saha B, Singh AK, Ghosh A. Identification and characterization of a vancomycin-resistant Staphylococcus aureus isolated from Kolkata (South Asia). J Med Microbiol 2008;57:172-9.
  • 5 Foster JK, Joseph R, Lentino RS, Divincenzo C. Comparison of in vitro activity of quinolone antibiotics and vancomycin against gentamicin- and methicillin-resistant Staphylococcus aureus by time-kill kinetic studies. Antimicrob Agents Chemother 1986;30:823-7.
  • 6 Gilbert MJ, Boscia A, Kobasa WD, Kaye D. Enoxacin compared with vancomycin for the treatment of experimental methicillin-resistant Staphylococcus aureus endocarditis. Antimicrob Agents Chemother 1986;29:461-3.
  • 7 Randrianirina F, Soares JL, Ratsima E, Carod JF, Combe P, Grosjean P, et al. In vitro activities of 18 antimicrobial agents against Staphylococcus aureus isolates from the Institute Pasteur of Madagascar. Ann Clin Microbiol Antimicrob 2007;6:5.
  • 8 Anbumani N, Kalyani J, Mallika M. Prevalence of methicillin-resistant Staphylococcus aureus in a Tertiary Referral Hospital in Chennai, South India. Indian J Pract Doct 2006-08-2006-09;3.
  • 9 Tyagi A, Kapil A, Singh P. Incidence of methicillin resistant Staphylococcus aureus (MRSA) in pus samples at a tertiary care hospital, AIIMS, New Delhi. J Indian Acad Clin Med 2008;9:33-5.
  • 10 Tiwari HK, Sapkota D, Sen RM. High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India. Infect Drug Resist 2008;1:57-61.
  • 11 Pai V, Rao VI, Rao SP. Prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus [MRSA] isolates at a tertiary care hospital in Mangalore, South India. J Lab Physicians 2010;2:82-4.
  • 12 Sarma JB, Ahmed GU. Characterization of methicillin resistant S. aureus strains and risk factors for acquisition in a teaching hospital in northeast India. Indian J Med Microbiol 2010;28:127-9.
  • 13 Qureshi AH, Rafi S, Qureshi SM, Ali AM. The current susceptibility patterns of methicillin resistant Staphylococcus aureus to conventional anti-staphylococcus antimicrobials at Rawalpindi. Pak J Med Sci 2004;20:361-4.
  • 14 Mehta AP, Rodrigues C, Sheth K, Jani S, Hakimiyan A, Fazalbhoy N. Control of methicillin resistant Staphylococcus aureus in a tertiary care Centre: A five-year study. J Med Microbiol 1998;16:31-4.
  • 15 Fernandez CJ, Ackerman VP. In vitro studies of ciprofloxacin and survey of resistance patterns in current isolates. Diagn Microbiol Infect Dis 1990;13:79-91.
  • 16 Tsering DC, Pal R, Kar S. Methicillin-resistant Staphylococcus aureus: Prevalence and current susceptibility pattern in Sikkim. J Glob Infect Dis 2011;3:9-13.
  • 17 Maple P, Hamilton JM, Brumfitt W. Ciprofloxacin resistance in methicillin- and gentamicin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis 1989;8:622-4.
  • 18 Deep A, Goel N, Sikka R, Chaudhary U, Yadav S, Gupta A, et al. Quinpristin dalfopristin resistance in gram positive bacteria: Experience from a tertiary care referral center in North India. J Infect Dis Antimicrob Agents 2008;25:117-21.
  • 19 Mehndiratta PL, Bhalla P. Typing of Methicillin resistant Staphylococcus aureus: A technical review. Indian J Med Microbiol 2012;30:16-23.