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Antibacterial drug release from a biphasic gel system: Mathematical modelling

Abrami M, Golob S, Pontelli F, Chiarappa G, Grassi G, Perissutti B, et al.

Int J Pharm, 2019 Mar 25;559:373-381.
PMID: 30716402 DOI: 10.1016/j.ijpharm.2019.01.055

Bacterial infections represent an important drawback in the orthopaedic field, as they can develop either immediately after surgery procedures or after some years. Specifically, in case of implants, they are alleged to be troublesome as their elimination often compels a surgical removal of the infected implant. A possible solution strategy could involve a local coating of the implant by an antibacterial system, which requires to be easily applicable, biocompatible and able to provide the desired release kinetics for the selected antibacterial drug. Thus, this work focusses on a biphasic system made up by a thermo-reversible gel matrix (Poloxamer 407/water system) hosting a dispersed phase (PLGA micro-particles), containing a model antibacterial drug (vancomycin hydrochloride). In order to understand the key parameters ruling the performance of this delivery system, we developed a mathematical model able to discriminate the drug diffusion inside micro-particles and within the gel phase, eventually providing to predict the drug release kinetics. The model reliability was confirmed by fitting to experimental data, proposing as a powerful theoretical approach to design and optimize such in situ delivery systems.

Matched MeSH terms: Vancomycin/chemistry
Fulltext Antibiotic resistance and plasmid profile of Escherichia coli isolated from ducks in Penang, Malaysia

Adzitey F., Ali, G.R.R., Huda, N., Ting, S.L.

International Food Research Journal, 2013;20(3):1473-1478.
MyJurnal

Fifty five (n=55) isolates of Escherichia coli isolated from ducks in Penang, Malaysia were examined for their susceptibility to eleven different antibiotics and assayed for the presence of plasmid DNAs. All the 55 Escherichia coli isolates were resistant (100%) to vancomycin. Higher resistance (= 60) occurred for tetracycline 51 (92.7%), ampicillin 40 (72.7%), streptomycin 37 (67.3%), and sulfamethoxazole-trimethophrim 37 (67.3%). No and low resistance was observed for nitrofurantoin (0%) and gentamicin (1.8%), respectively. The isolates also showed some intermediate resistances to all antibiotics examined except for vancomycin. The 55 Escherichia coli isolates exhibited 23 different antibiotic resistant patterns with MAR index ranging from 0.09-0.82. Majority of the Escherichia coli isolates exhibited resistant pattern of VA-C-OFX-SXT-TE-AMP-NA-KF and VA-S-C-OFX-SXT-TE-AMP-NA-KF with MAR index of 0.73 and 0.82, respectively. The smallest plasmid DNA size was 1.2 kb and the largest plasmid DNA size was 81.5 kb. 51 (93%) of the duck Escherichia coli isolates harbored plasmids. The was no direct correlation between plasmid DNA sizes and antibiotic resistant among the duck Escherichia coli isolates. Thus, the antibiotic resistant of the Escherichia coli isolates could mostly be mediated by chromosomes instead of plasmids. This study also suggests that the use of antibiotics in duck farming in Penang, Malaysia needs to be controlled to prevent the spread of multiple antibiotic resistant Escherichia coli isolates.

Matched MeSH terms: Vancomycin
Fulltext Intraperitoneal Antibiotic Utilization among Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients with Peritonitis at a Tertiary Hospital Setting in Malaysia

Ahmad M, Zin CS, Ab Rahman AF

J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S737-S742.
PMID: 33828370 DOI: 10.4103/jpbs.JPBS_298_19

Introduction: Patients receiving continuous ambulatory peritoneal dialysis (CAPD) are commonly associated with peritonitis. However, little is known about the utilization of antibiotics for the treatment of peritonitis in these patients.
Objectives: This study aimed to evaluate the patterns of intraperitoneal (IP) antibiotic utilization for the treatment of peritonitis in CAPD patients.
Materials and Methods: This is a retrospective study conducted at a tertiary hospital setting in Malaysia. Medical records of CAPD patients who were diagnosed with peritonitis and registered with National Kidney Registry from 2013 to 2018 were reviewed. Types of antibiotics used and its dose and duration were recorded and reported using the anatomical therapeutic chemical/defined daily dose (ATC/DDD) system.
Results: A total of 105 peritonitis episodes were recorded from 72 patients. The most common first-line empirical antibiotic combinations used were ceftazidime/cefazolin (40%, n = 42), followed by cefepime/cefazolin (30.5%, n = 32) and ceftazidime/cloxacillin (25.7%, n = 27). The definitive therapy for culture-proven CAPD-related peritonitis (CAPD-P) showed that vancomycin was the most frequently prescribed antibiotic (31.7%, n = 26/82), followed by amikacin (14.6%, n = 12/82), meropenem (11%, n = 9/82) and ampicillin (11%, n = 9/82). Ciprofloxacin was among the least prescribed definitive antibiotics for CAPD-P (2.4%, n = 2/82) but the DDD/100 patient-days estimates showed that it had the highest therapeutic intensity.
Conclusion: There are various IP antibiotics used for CAPD-P and the most common empirical therapy was the combination of ceftazidime and cefazolin while vancomycin is predominantly used for definitive therapy. Future studies to evaluate the clinical outcomes of the antibiotic use should be conducted to have a better insight on the efficacy of the peritonitis treatment.

Matched MeSH terms: Vancomycin
Increased vancomycin minimum inhibitory concentration among Staphylococcus aureus isolates in Malaysia

Ahmad N, Nawi S, Rajasekaran G, Maning N, Aziz MN, Husin A, et al.

J Med Microbiol, 2010 Dec;59(Pt 12):1530-1532.
PMID: 20724515 DOI: 10.1099/jmm.0.022079-0
Matched MeSH terms: Vancomycin/pharmacology*
Fulltext Genotypic variations of virulent genes in Enterococcus faecium and Enterococcus faecalis isolated from three hospitals in Malaysia

Al-Talib H, Zuraina N, Kamarudin B, Yean CY

Adv Clin Exp Med, 2015 Jan-Feb;24(1):121-7.
PMID: 25923096 DOI: 10.17219/acem/38162

The genus Enterococcus is of increasing significance as a cause of nosocomial infections, and this trend is exacerbated by the development of antibiotic resistance.

Matched MeSH terms: Vancomycin/therapeutic use; Vancomycin Resistance
Fulltext Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007

Al-Talib HI, Yean CY, Al-Jashamy K, Hasan H

Ann Saudi Med, 2010 Sep-Oct;30(5):358-63.
PMID: 20697171 DOI: 10.4103/0256-4947.67077

Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. The aim of the present study was to assess the burden of MRSA nosocomial infection, its association with factors of interest, and its antimicrobial susceptibility.

Matched MeSH terms: Vancomycin/pharmacology
Fulltext Contact lens related Elizabethkingia meningoseptica keratitis-a first Southeast ASEAN case report & literature review

Ang, Wen-Jeat, Embong Zunaina, Raja Omar Raja Norliza, Abdul Jalil Fadzillah

Journal of Biomedical and Clinical Sciences, 2017;2(1):1-4.
MyJurnal

We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningosepticaregistered in Southeast Asia. A 20-year-old female student who wasa regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E.meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E.meningosepticakeratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.

Matched MeSH terms: Vancomycin
Fulltext Enterobacter gergoviae peritonitis in a patient on chronic ambulatory peritoneal dialysis - first reported case

Anna Misya’il Abdul Rashid, Lim, Christopher Thiam Seong

Malaysian Journal of Medicine and Health Sciences, 2017;13(2):67-69.
MyJurnal

Enterobacter gergoviae is a gram negative rod-shaped opportunistic organism reported to cause urinary and respiratory tract infections, but peritonitis caused by this organism is unknown. We report a case of 50-year-old patient on peritoneal dialysis (PD) presented with Enterobacter gergoviae peritonitis with septic shock. Despite Intraperitoneal (IP) cloxacillin 250mg qid and IP ceftazidime 1gram q24h and subsequent escalation with IP amikacin 2mg/kg q24h and IP vancomycin 15mg/kg q24h within the next 48 hours, his peritonitis remained refractory and required catheter removal. Although Enterobacter gergoviae is naturally sensitive to aminoglycosides, carbapenems and quinolones, it reacts differently to the beta lactam antibiotics. Their resistance to third-generation cephalosporins is fast emerging and treatment with third-generation cephalosporins may cause AmpC-overproducing mutants. The majority of
Enterobacteriaceae, including Extended-spectrum beta-lactamases producers, remain susceptible to carbapenems. Our report provides an unfavourable course of E. gergoviae peritonitis likely due to acquired secondary drug resistance during the therapy period.

Matched MeSH terms: Vancomycin
Cefepime monotherapy for treatment of febrile neutropenia in children

Ariffin H, Ai CL, Lee CL, Abdullah WA

J Paediatr Child Health, 2006 Dec;42(12):781-4.
PMID: 17096713

Empirical therapy for children with febrile neutropenia has traditionally consisted of combination antibiotics, usually a beta-lactam and an aminoglycoside. However, recent trends and international guidelines have now made monotherapy a feasible option in the management of this group of patients. We prospectively evaluated the efficacy and safety of cefepime monotherapy in our population of paediatric cancer patients with febrile neutropenia.

Matched MeSH terms: Vancomycin/therapeutic use
Fulltext Overcoming antibiotic resistance in the hospital: a never ending battle

Ariza Adnan

Medical Health Reviews, 2008;2008(1):29-44.
MyJurnal

The issue of antibiotic resistance has been around ever since the first antibiotic penicillin was introduced to the world. It continues to rise, becoming a major problem across the globe and Malaysia is no exception. Hospital is a critical component of the antibiotic resistance problem worldwide. The problems of antibiotic resistance are typically magnified in a hospital setting due to the common variables in the hospital environment that favour its development. These include a combination of highly susceptible patients, intensive and prolonged antibiotic use, and crossinfection resulting in nosocomial infections with highly resistant bacterial pathogens such as multi-resistant gram-negative rods, vancomycin resistant enterococci (VRE) and methicillinresistant Staphylococcus aureus (MRSA) as well as resistant fungal infections. Transmission of highly resistant bacteria from patient to patient within the hospital environment amplifies the problem of antibiotic resistance and may result in the infection of patients who are not receiving antibiotics. Transmission of antibiotic-resistant strains from hospital personnel to patients or vice versa may also occur. What are the available strategies and what works best in managing antibiotic resistance in the hospital? This review will highlight the seriousness of the resistance problem and identify actions that address it especially in the context of improving the problem in Malaysian hospitals.

Matched MeSH terms: Vancomycin-Resistant Enterococci
Evaluation of reported adverse drug reactions in antibiotic usage: a retrospective study from a tertiary care hospital, Malaysia

Arulappen AL, Danial M, Sulaiman SAS

Front Pharmacol, 2018;9:809.
PMID: 30177879 DOI: 10.3389/fphar.2018.00809

Adverse drug reaction (ADR) primarily caused by many drugs including antibiotics. At present, the incidence and pattern of ADR caused by antibiotics have remained as neglected area in Malaysia. This study was conducted to determine the incidence and analyze the pattern of ADR caused by antibiotics among patients in a tertiary care hospital. It is a 2-year retrospective observational study conducted at Hospital Pulau Pinang, Malaysia. All eligible patients who had antibiotic prescribed belonging to any age group either from outpatient or inpatient that had experienced ADR was included in this study. The outcomes were measured with the aid of Naranjo's and Hartwig's scales. The incidence of the ADRs among patients prescribed with antibiotics in Hospital Pulau Pinang is about 1.1%. Vancomycin and Trimethoprim/Sulfamethoxazole both are considered to be the major contributors to ADR incidences. The skin was the most affected organ by ADRs followed by gastrointestinal system. Most of the severe ADRs were caused by Penicillin. The causality relationship of all the severe reactions was mostly probable. General Medicine unit had reported the highest number of ADRs caused by antibiotics. The common manifestations of ADRs are acute kidney injury and exanthem. In addition, majority of the ADRs caused by antibiotics were reversible. A large multicenter study is suggested to confirm the present findings.

Study site: Hospital Pulau Pinang

Matched MeSH terms: Vancomycin
Fulltext Preliminary Screening of Antibacterial Activity Using Crude Extracts of Hibiscus rosa sinensis

Arullappan S, Zakaria Z, Basri DF

Trop Life Sci Res, 2009 Dec;20(2):109-18.
PMID: 24575183 MyJurnal

Hibiscus rosa sinensis, a member of the Malvaceae family, is widely cultivated in the tropics as an ornamental plant. It is often planted as a fence or hedge plant, and has several forms of flowers with varying colours. It is also used in traditional medicine to induce abortion, ease menstrual cramps, assist in childbirth and relieve headache, fever and inflammation. In this study, we evaluated the antibacterial activity of H. rosa sinesis extract using a disc diffusion method. Crude petroleum ether extract, ethyl acetate extract and methanol extract from the leaves, stems and flowers of the plant were prepared using a cold extraction technique. These extracts were tested at concentrations ranging from 4 mg/disc to 0.017 mg/disc against methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia. The petroleum ether extract from the leaves, stems and flowers and methanol extract from the leaves showed inhibition zones with diameters > 12 mm against MRSA. Overall, the petroleum ether extract from flowers at concentrations of 4 mg/disc and 2 mg/disc displayed the strongest inhibition zones of 18.6 ± 2.85 mm and 18.5 ± 0.29 mm, respectively, as compared to vancomycin (30 μg/ml), which did not differ significantly from the 18.0 ± 0.10 mm size of the vancomycin (30 μg/ml) inhibition zone (p < 0.05). In conclusion, H. rosa sinensis extract is a potential antibacterial agent for treating MRSA infection.

Matched MeSH terms: Vancomycin
Fulltext Clinical and microbiological evaluation of stabilised periodontal patients undergoing early stage of orthodontic treatment

Asma, A.A.A., Rohaya, M.A.W., Juhaida, S., Badiah, B., Zaleha, S.

Medicine & Health, 2020;15(2):96-107.
MyJurnal

Rawatan ortodontik boleh menjejaskan keseimbangan mikrobiota oral yang memainkan peranan utama dalam etiologi penyakit periodontium. Kajian klinikal prospektif ini bertujuan untuk menilai kesihatan periodontal dan profil mikrobiologi pesakit periodontal yang sihat (Kumpulan 1) dan yang telah stabil (Kumpulan 2) selama tiga bulan pertama semasa rawatan ortodontik. Aplian ortodontik atas dan bawah tetap dipasang. Kesihatan periodontium dinilai menggunakan skor plak (PS), pendarahan pada probing (BOP) dan kedalaman poket (PD). 29 tapak telah diambil untuk persampelan plak subgingival. Sampel plak diinokulasikan pada agar Trypticase Soya Darah (TSBA) dan agar Trypticase Soya Bacitracin Vancomycin (TSBV) untuk penilaian aerob, anaerob, bakteria berpigmen hitam (BPH) dan Aggregatibacter actinomycetemcomitans. Semua ukuran diambil sebelum pendakap gigi dipasang (T0), 1 minggu (T1), 1 bulan (T2) dan 3 bulan selepas dipasang pendakap gigi (T3). Secara umumnya, kesihatan periodontium dalam kedua-dua kumpulan hampir sama. Selepas 1 minggu, bilangan aerob adalah lebih tinggi dalam Kumpulan 1 (88%) manakala anaerob adalah lebih tinggi dalam Kumpulan 2 (45%). A. actinomycetemcomitans lebih tinggi dalam Kumpulan 1 pada T0 dan T1 tetapi jauh lebih tinggi dalam Kumpulan 2 di T3. BPH adalah minimal pada setiap masa dengan tiada perbezaan signifikan. Oleh itu, semasa 3 bulan pertama rawatan ortodontik dijalankan, terdapat perubahan ketara dalam bilangan aerob-anaerob pada kedua-dua pesakit periodontal yang sihat dan stabil. Bakteria patogenik akan meningkat semasa rawatan awal ortodontik.

Matched MeSH terms: Vancomycin
Fulltext Genotypically different clones of Staphylococcus aureus are diverse in the antimicrobial susceptibility patterns and biofilm formations

Atshan SS, Nor Shamsudin M, Lung LT, Sekawi Z, Pei Pei C, Karunanidhi A, et al.

Biomed Res Int, 2013;2013:515712.
PMID: 24455699 DOI: 10.1155/2013/515712

This study evaluated whether genotypically different clinical isolates of S. aureus have similar susceptibilities to individual antibiotics. It further aims to check the impact of biofilm on the in vitro activity of vancomycin, daptomycin, linezolid, and tigecycline against S. aureus clones. The study used a total of 60 different clinical MSSA and MRSA isolates. Susceptibilities were performed in planktonic cultures by macrobroth dilution and epsilon-test (E test) system. Biofilm production was determined using an adherent plate assay. The efficacy of antimicrobial activities against biofilms formation was checked using confocal laser scanning microscopy (CLSM). The study found that similar and different spa, MLST, and SCCmec types displayed high variation in their susceptibilities to antibiotics with tigecycline and daptomycin being the most effective. The biofilms were found resistant to high concentrations of most antibiotics tested with daptomycin being the most effective drug used in adhesive biofilms. A considerable difference exists among similar and various clone types against antibiotics tested. This variation could have contributed to the degree of virulence even within the same clonal genotype and enhanced heterogeneity in the infection potential. Thus, the development of a rapid and precise identification profile for each clone in human infections is important.

Matched MeSH terms: Vancomycin/pharmacology
Antimicrobial activity of a quaternized BODIPY against Staphylococcus strains

Aydın Tekdaş D, Viswanathan G, Zehra Topal S, Looi CY, Wong WF, Min Yi Tan G, et al.

Org Biomol Chem, 2016 Mar 7;14(9):2665-70.
PMID: 26831779 DOI: 10.1039/c5ob02477c

A novel BODIPY derivative was designed for biomedical applications. Its mono-quaternized structure ensured its water-solubility and suitable amphiphilicity. Showing no singlet oxygen generation to avoid damage to healthy cells, this new derivative proved to be an extremely promising antimicrobial agent, with activity equal or superior to ampicillin against MRS Staphylococcus strains with no short-term resistance issue. Its activity against MSS Staphylococcus strains was largely superior to those of ampicillin and reached the activity of vancomycin against MSS S. epidermidis. This latter result is in particular extremely promising for the treatment of hospital-acquired infections. Also the fluorescence properties of BODIPY allowed imaging of the uptake.

Matched MeSH terms: Vancomycin
Synergy of flavone with vancomycin and oxacillin against vancomycin-intermediate Staphyloccus aureus

Bakar NS, Zin NM, Basri DF

Pak J Pharm Sci, 2012 Jul;25(3):633-8.
PMID: 22713953

This study evaluated in vitro activity of 9 flavonoids in combination with vancomycin or oxacillin against vancomycin-intermediate Staphylococcus aureus (VISA) ATCC 700699 by employing the checkerboard method to obtain Minimal inhibitory concentration (MIC) and fractional inhibitory concentration (FIC) index. Six flavonoids namely hesperitin, rutin, naringenin, flavones, naringin and 3, 7-dihyroxyflavone which exhibited notable inhibitory activity (MIC values < 3200 μg/ml) were further evaluated for combination assay with antibiotics. The combinations of vancomycin+flavone and oxacillin+flavone were found synergistic with the FIC index value 0.094 and 0.126, respectively. Other combinations showed an additive interaction (FIC index = 1.063) but no antagonistic reaction (FIC index > 4) were observed. In time kill studies, oxacillin-flavone combination at synergistic concentration demonstrated bactericidal effect at 24 h period with concentration-dependent manner on the VISA strain. Following 1 h exposure, the combination also produced persistent effect on the bacteria growth for 2.9 hrs at 1x sub-MIC and more than 24 h at 5x of sub-MIC and there was a significant difference between both concentrations (p<0.05). Vancomycin-flavone combination, however, showed no concentration-dependent effect and lower PAE values (1.159 h and 2.322 h at 1x and 5x sub-MIC, respectively) on the VISA strain. In conclusion, flavone markedly intensifies the susceptibility of oxacillin against VISA and the combination can be implicated for further interaction studies at molecular level.

Matched MeSH terms: Vancomycin/pharmacology*
Fulltext Bacteriostatic antimicrobial combination: antagonistic interaction between epsilon-viniferin and vancomycin against methicillin-resistant Staphylococcus aureus

Basri DF, Xian LW, Abdul Shukor NI, Latip J

Biomed Res Int, 2014;2014:461756.
PMID: 24783205 DOI: 10.1155/2014/461756

Stilbenoids have been considered as an alternative phytotherapeutic treatment against methicillin-resistant Staphylococcus aureus (MRSA) infection. The combined effect of ε-viniferin and johorenol A with the standard antibiotics, vancomycin and linezolid, was assessed against MRSA ATCC 33591 and HUKM clinical isolate. The minimum inhibitory concentration (MIC) value of the individual tested compounds and the fractional inhibitory concentration index (FICI) value of the combined agents were, respectively, determined using microbroth dilution test and microdilution checkerboard (MDC) method. Only synergistic outcome from checkerboard test will be substantiated for its rate of bacterial killing using time-kill assay. The MIC value of ε -viniferin against ATCC 33591 and johorenol A against both strains was 0.05 mg/mL whereas HUKM strain was susceptible to 0.1 mg/mL of ε-viniferin. MDC study showed that only combination between ε-viniferin and vancomycin was synergistic against ATCC 33591 (FICI 0.25) and HUKM (FICI 0.19). All the other combinations (ε-viniferin-linezolid, johorenol A-vancomycin, and johorenol A-linezolid) were either indifferent or additive against both strains. However, despite the FICI value showing synergistic effect for ε-viniferin-vancomycin, TKA analysis displayed antagonistic interaction with bacteriostatic action against both strains. As conclusion, ε-viniferin can be considered as a bacteriostatic stilbenoid as it antagonized the bactericidal activity of vancomycin. These findings therefore disputed previous report that ε-viniferin acted in synergism with vancomycin but revealed that it targets similar site in close proximity to vancomycin's action, possibly at the bacterial membrane protein. Hence, this combination has a huge potential to be further studied and developed as an alternative treatment in combating MRSA in future.

Matched MeSH terms: Vancomycin/administration & dosage*
Fulltext Evaluation of the Combined Effects of Stilbenoid from Shorea gibbosa and Vancomycin against Methicillin-Resistant Staphylococcus aureus (MRSA)

Basri DF, Luoi CK, Azmi AM, Latip J

Pharmaceuticals (Basel), 2012;5(9):1032-43.
PMID: 24280704 DOI: 10.3390/ph5091032

The aim of this study is to determine the combined effects of stilbenoids from Shorea gibbosa and vancomycin against methicillin-resistant Staphylococcus aureus (MRSA). A total of nine pure compounds, five stilbenoid dimers ε-viniferin, ampelopsin A, balanocarpol, laevifonol and diptoindonesin G and four stilbenoid trimers a-viniferin, johorenol A, ampelopsin E and vaticanol G were evaluated for their antibacterial activities against ATCC 33591 and a HUKM clinical isolate. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for each active compound were determined using the serial microdilution and plate-streak techniques. The combined effect of stilbenoids with vancomycin against MRSA was evaluated using the checkerboard assay to determine their fractional inhibitory concentration (FIC) index values. The MIC value of a-viniferin on both MRSA strains was 100 μg/mL, whereas those of johorenol A on ATCC 33591 and HUKM strain were 100 μg/mL and 200 μg/mL, respectively. The MIC values of ampelopsin E and vaticanol G were higher than 400 μg/mL. Out of the five stilbenoid dimers, only ε-viniferin was capable of inhibiting the growth of both MRSA strains at MIC 400 μg/mL. The MBC value of ε-viniferin, a-viniferin and johorenol A showed bacteriostatic action against MRSA. The FIC index value of ε-viniferin and a-viniferin in combination with vancomycin showed an additive effect (0.5 < FIC ≤ 2.0) against both MRSA strains. Johorenol A-vancomycin combination was also additive against HUKM strain, but it showed synergistic interaction with vancomycin against ATCC 33591 (FIC < 0.5). Stilbenoid compounds from Shorea gibbosa have anti-MRSA activity and huge potential as an alternative phytotherapy in combating MRSA infections.

Matched MeSH terms: Vancomycin
Fulltext Synergistic Interaction of Methanol Extract from Canarium odontophyllum Miq. Leaf in Combination with Oxacillin against Methicillin-Resistant Staphylococcus aureus (MRSA) ATCC 33591

Basri DF, Sandra V

Int J Microbiol, 2016;2016:5249534.
PMID: 27006659 DOI: 10.1155/2016/5249534

Canarium odontophyllum (CO) Miq. has been considered as one of the most sought-after plant species in Sarawak, Malaysia, due to its nutritional and pharmacological benefits. This study aimed to evaluate the pharmacodynamic interaction of crude methanol and acetone extracts from CO leaves in combination with oxacillin, vancomycin, and linezolid, respectively, against MRSA ATCC 33591 as preliminary study has reported its potential antistaphylococcal activity. The broth microdilution assay revealed that both methanol and acetone extracts were bactericidal with Minimum Inhibitory Concentration (MIC) of 312.5 μg/mL and 156.25 μg/mL and Minimum Bactericidal Concentration (MBC) of 625 μg/mL and 312.5 μg/mL, respectively. Fractional Inhibitory Concentration (FIC) indices were obtained via the chequerboard dilution assay where methanol extract-oxacillin, acetone extract-oxacillin, methanol extract-linezolid, and acetone extract-linezolid combinations exhibited synergism (FIC index ≤ 0.5). The synergistic action of the methanol extract-oxacillin combination was verified by time-kill analysis where bactericidal effect was observed at concentration of 1/8 × MIC of both compounds at 9.6 h compared to oxacillin alone. As such, these findings postulated that both extracts exert their anti-MRSA mechanism of action similar to that of vancomycin and provide evidence that the leaves of C. odontophyllum have the potential to be developed into antistaphylococcal agents.

Matched MeSH terms: Vancomycin
Fulltext Pharmacodynamic Interaction of Quercus infectoria Galls Extract in Combination with Vancomycin against MRSA Using Microdilution Checkerboard and Time-Kill Assay

Basri DF, Khairon R

Evid Based Complement Alternat Med, 2012;2012:493156.
PMID: 22899953 DOI: 10.1155/2012/493156

The galls of Quercus infectoria Olivier possess astringent properties which helps in the tightening of the vaginal epithelium in the post-natal period. The present study aimed to observe the time-kill kinetics of the acetone and methanol extracts of gall of Q. infectoria in combination with vancomycin against two methicillin-resistant Staphylococcus aureus (MRSA) strains; ATCC 33591 and MU 9495 (laboratory-passaged strain). Minimum inhibitory concentration (MIC) of the extracts were determined using microdilution technique whereas the checkerboard and time-kill kinetics were employed to verify the synergistic effects of treatment with vancomycin. The FIC index value of the combinations against both MRSA strains showed that the interaction was synergistic (FIC index <0.5). Time-kill assays showed the bactericidal effect of the combination treatment at 1/8XMIC of the extract and 1/8XMIC of vancomycin, were respectively at 7.2 ± 0.28 hr against ATCC 33591 compared to complete attenuation of the growth of the same strain after 8 hr of treatment with vancomycin alone. In conclusion, the combination extracts of Q. infectoria with vancomycin were synergistic according to FIC index values. The time-kill curves showed that the interaction was additive with a more rapid killing rate but, which did not differ significantly with vancomycin.

Matched MeSH terms: Vancomycin

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