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Antibiotic susceptibility among Staphylococcus epidermidis isolated from prosthetic joint infections, with focus on doxycycline
Department of Laboratory Medicine, Clinical Microbiology, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Laboratory Medicine, Clinical Microbiology, Örebro University, Örebro, Sweden.
Department of Infectious Diseases, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Örebro University, School of Medicine, Örebro University, Sweden. Department of Laboratory Medicine, Clinical Microbiology, Örebro University, Örebro, Sweden.ORCID iD: 0000-0001-5939-2932
2015 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 123, no 12, p. 1055-1060Article in journal (Refereed) Published
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Abstract [en]

In recent years, coagulase-negative staphylococci such as Staphylococcus epidermidis have gained importance as nosocomial pathogens, especially in immunocompromised patients and prosthetic joint infections (PJIs). These infections are often long lasting and difficult to treat due to the production of bacterial biofilm and the transformation of the bacteria into a stationary growth phase. Rifampicin is able to penetrate the biofilm, but to reduce the risk of development of rifampicin resistance it should be used in combination with an additional antibiotic. In this study we used Etest to investigate the antimicrobial susceptibility of 134 clinical isolates of S.epidermidis obtained from PJIs to six oral antibiotics: doxycycline, rifampicin, linezolid, fusidic acid, clindamycin, and ciprofloxacin. We also performed synergy testing on doxycycline in combination with each of the remaining antibiotics. Ninety-three (69%) of the 134 isolates were susceptible to doxycycline, 94/134 (70%) to rifampicin, 56/134 (42%) to clindamycin, 25/134 (19%) to ciprofloxacin, 81/134 (60%) to fusidic acid, and 100% to linezolid. Thirty-two (80%) of the 40 isolates not fully susceptible to rifampicin were susceptible to doxycycline. Doxycycline in combination with each of the other investigated antibiotics exerted an additive effect on nearly half of the isolates, with the exception of clindamycin, which displayed an even higher percentage of additive effect (69%). To conclude, as the majority of the S.epidermidis isolates were susceptible to doxycycline, this antimicrobial agent may provide a potential alternative for combination therapy together with rifampicin.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 123, no 12, p. 1055-1060
Keywords [en]
Implant infection, prosthetic joint infection, synergy testing, Etest, doxycycline
National Category
Immunology in the medical area
Research subject
Immunology
Identifiers
URN: urn:nbn:se:oru:diva-47005DOI: 10.1111/apm.12465ISI: 000364779600008PubMedID: 26547372Scopus ID: 2-s2.0-84946430033OAI: oai:DiVA.org:oru-47005DiVA, id: diva2:878703
Note

Funding Agency:

Östergötland County Council

Available from: 2015-12-09 Created: 2015-12-09 Last updated: 2018-07-02Bibliographically approved

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Hellmark, BengtSöderquist, Bo

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School of Health and Medical Sciences, Örebro University, SwedenSchool of Medicine, Örebro University, Sweden
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Immunology in the medical area

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