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Fulltext Functional and molecular surveillance of Helicobacter pylori antibiotic resistance in Kuala Lumpur

Teh X, Khosravi Y, Lee WC, Leow AH, Loke MF, Vadivelu J, et al.

PLoS One, 2014;9(7):e101481.
PMID: 25003707 DOI: 10.1371/journal.pone.0101481

Helicobacter pylori is the etiological agent for diseases ranging from chronic gastritis and peptic ulcer disease to gastric adenocarcinoma and primary gastric B-cell lymphoma. Emergence of resistance to antibiotics possesses a challenge to the effort to eradicate H. pylori using conventional antibiotic-based therapies. The molecular mechanisms that contribute to the resistance of these strains have yet to be identified and are important for understanding the evolutional pattern and selective pressure imposed by the environment.

Matched MeSH terms: Fluoroquinolones/pharmacology
Fulltext Role of prophylactic antibiotics in cirrhotic patients with variceal bleeding

Lee YY, Tee HP, Mahadeva S

World J Gastroenterol, 2014 Feb 21;20(7):1790-6.
PMID: 24587656 DOI: 10.3748/wjg.v20.i7.1790

Bacterial infections are common in cirrhotic patients with acute variceal bleeding, occurring in 20% within 48 h. Outcomes including early rebleeding and failure to control bleeding are strongly associated with bacterial infection. However, mortality from variceal bleeding is largely determined by the severity of liver disease. Besides a higher Child-Pugh score, patients with hepatocellular carcinoma are particularly susceptible to infections. Despite several hypotheses that include increased use of instruments, greater risk of aspiration pneumonia and higher bacterial translocation, it remains debatable whether variceal bleeding results in infection or vice versa but studies suggest that antibiotic prophylaxis prior to endoscopy and up to 8 h is useful in reducing bacteremia and spontaneous bacterial peritonitis. Aerobic gram negative bacilli of enteric origin are most commonly isolated from cultures, but more recently, gram positives and quinolone-resistant organisms are increasingly seen, even though their clinical significance is unclear. Fluoroquinolones (including ciprofloxacin and norfloxacin) used for short term (7 d) have the most robust evidence and are recommended in most expert guidelines. Short term intravenous cephalosporin (especially ceftriaxone), given in a hospital setting with prevalent quinolone-resistant organisms, has been shown in studies to be beneficial, particularly in high risk patients with advanced cirrhosis.

Matched MeSH terms: Fluoroquinolones/therapeutic use
Fulltext Prevalence of multidrug resistance Campylobacter jejuni and Campylobacter coli in chickens slaughtered in selected markets, Malaysia

Mansouri-najand L, Saleha AA, Wai SS

Trop Biomed, 2012 Jun;29(2):231-8.
PMID: 22735845 MyJurnal

The objectives of this study were to determine the occurrence of Campylobacter spp. in live chickens sold at wet markets in Selangor, Malaysia and the multidrug resistance (MDR) profiles of the isolates. Cloacal swabs were taken from the chickens before slaughter and their caecal mucosae were swabbed after slaughter. Of the 90 chickens examined, 68 (75.6%) were positive for Campylobacter. Campylobacter were recovered from caecal swabs (53/90) and cloacal swabs (34/90) and Campylobacter coli (46 isolates) were identified slightly more than Campylobacter jejuni (41 isolates), but these differences were not significant (p<0.05). The most frequently observed resistance was to cephalothin (95.5%), followed by tetracycline (80.8%), erythromycin (51.4%), enrofloxacin (42.4%) and gentamicin (24.4%). Multidrug resistance (resistant to four or more antibiotics) was detected in 35.3% isolates. Campylobacter jejuni showed nine resistance profiles and the most common was to gentamicin-eryhtromycin-enrofloxacin-cephalothin-tetracycline (32.4%) combination while C. coli showed six profiles, with cephalothin-tetracycline (32.2%) combination being most common.

Matched MeSH terms: Fluoroquinolones/pharmacology
Helicobacter pylori management in ASEAN: The Bangkok consensus report

Mahachai V, Vilaichone RK, Pittayanon R, Rojborwonwitaya J, Leelakusolvong S, Maneerattanaporn M, et al.

J Gastroenterol Hepatol, 2018 Jan;33(1):37-56.
PMID: 28762251 DOI: 10.1111/jgh.13911

Helicobacter pylori (H. pylori) infection remains to be the major cause of important upper gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. H. pylori management in ASEAN: the Bangkok consensus report gathered key opinion leaders for the region to review and evaluate clinical aspects of H. pylori infection and to develop consensus statements, rationales, and grades of recommendation for the management of H. pylori infection in clinical practice in ASEAN countries. This ASEAN Consensus consisted of 34 international experts from 10 ASEAN countries, Japan, Taiwan, and the United States. The meeting mainly focused on four issues: (i) epidemiology and disease association; (ii) diagnostic tests; (iii) management; and (iv) follow-up after eradication. The final results of each workshop were presented for consensus voting by all participants. Statements, rationale, and recommendations were developed from the available current evidence to help clinicians in the diagnosis and treatment of H. pylori and its clinical diseases.

Matched MeSH terms: Fluoroquinolones/administration & dosage
Pharmacokinetic/Pharmacodynamics-Optimized Antimicrobial Therapy in Patients with Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia

Sulaiman H, Abdul-Aziz MH, Roberts JA

Semin Respir Crit Care Med, 2017 06;38(3):271-286.
PMID: 28578552 DOI: 10.1055/s-0037-1602716

Hospital-acquired pneumonia and ventilator-associated pneumonia continue to cause significant morbidity and mortality. With increasing rates of antimicrobial resistance, the importance of optimizing antibiotic treatment is key to maximize treatment outcomes. This is especially important in critically ill patients in intensive care units, in whom the infection is usually caused by less susceptible organisms. In addition, the marked physiological changes that can occur in these patients can cause serious changes in antibiotic pharmacokinetics which in turn alter the attainment of therapeutic drug exposures. This article reviews the various aspects of the pharmacokinetic changes that can occur in the critically ill patients, the barriers to achieving therapeutic drug exposures in pneumonia for systemically delivered antibiotics, the optimization for commonly used antibiotics in hospital- and ventilator-associated pneumonia, the agents that should be avoided in the treatment regimen, as well as the use of adjunctive therapy in the form of nebulized antibiotics.

Matched MeSH terms: Fluoroquinolones/pharmacokinetics
Application of diverse natural polymers in the design of oral gels for the treatment of periodontal diseases

Ganguly A, Ian CK, Sheshala R, Sahu PS, Al-Waeli H, Meka VS

J Mater Sci Mater Med, 2017 Mar;28(3):39.
PMID: 28144851 DOI: 10.1007/s10856-017-5852-4

The objective of this study was to prepare periodontal gels using natural polymers such as badam gum, karaya gum and chitosan. These gels were tested for their physical and biochemical properties and assessed for their antibacterial activity against Aggregatibacter actinomycetemcomitans and Streptococcus mutans, two pathogens associated with periodontal disease. Badam gum, karaya gum and chitosan were used to prepare gels of varying concentrations. Moxifloxacin hydrochloride, a known antimicrobial drug was choosen in the present study and it was added to the above gels. The gels were then run through a battery of tests in order to determine their physical properties such as pH and viscosity. Diffusion studies were carried out on the gels containing the drug. Antimicrobial testing of the gels against various bacteria was then carried out to determine the effectiveness of the gels against these pathogens. The results showed that natural polymers can be used to produce gels. These gels do not have inherent antimicrobial properties against A. actinomycetemcomitans and S. mutans. However, they can be used as a transport vehicle to carry and release antimicrobial drugs.

Matched MeSH terms: Fluoroquinolones/chemistry
Fulltext Genomic and RT-qPCR analysis of trimethoprim-sulfamethoxazole and meropenem resistance in Burkholderia pseudomallei clinical isolates

Schnetterle M, Gorgé O, Nolent F, Boughammoura A, Sarilar V, Vigier C, et al.

PLoS Negl Trop Dis, 2021 Feb;15(2):e0008913.
PMID: 33592059 DOI: 10.1371/journal.pntd.0008913

BACKGROUND: Melioidosis is an endemic disease in southeast Asia and northern Australia caused by the saprophytic bacteria Burkholderia pseudomallei, with a high mortality rate. The clinical presentation is multifaceted, with symptoms ranging from acute septicemia to multiple chronic abscesses. Here, we report a chronic case of melioidosis in a patient who lived in Malaysia in the 70s and was suspected of contracting tuberculosis. Approximately 40 years later, in 2014, he was diagnosed with pauci-symptomatic melioidosis during a routine examination. Four strains were isolated from a single sample. They showed divergent morphotypes and divergent antibiotic susceptibility, with some strains showing resistance to trimethoprim-sulfamethoxazole and fluoroquinolones. In 2016, clinical samples were still positive for B. pseudomallei, and only one type of strain, showing atypical resistance to meropenem, was isolated.
PRINCIPAL FINDINGS: We performed whole genome sequencing and RT-qPCR analysis on the strains isolated during this study to gain further insights into their differences. We thus identified two types of resistance mechanisms in these clinical strains. The first one was an adaptive and transient mechanism that disappeared during the course of laboratory sub-cultures; the second was a mutation in the efflux pump regulator amrR, associated with the overexpression of the related transporter.
CONCLUSION: The development of such mechanisms may have a clinical impact on antibiotic treatment. Indeed, their transient nature could lead to an undiagnosed resistance. Efflux overexpression due to mutation leads to an important multiple resistance, reducing the effectiveness of antibiotics during treatment.

Matched MeSH terms: Fluoroquinolones
Point prevalence surveys of antimicrobial use: a systematic review and the implications

Saleem Z, Hassali MA, Godman B, Versporten A, Hashmi FK, Saeed H, et al.

Expert Rev Anti Infect Ther, 2020 09;18(9):897-910.
PMID: 32394754 DOI: 10.1080/14787210.2020.1767593

Introduction: In view of increasing concerns with antimicrobial resistance (AMR), the World Health Organization (WHO) instituted a Global Action Plan (GAP) to address this. Area covered: One of the strategies to achieve the goals of GAP is to conduct regular surveillance of antimicrobial use through point prevalence surveys (PPS). In this review, PubMed, EBSCO, Proquest, Cinahl, and Scopus were searched for PPS of antimicrobial use published in English between January 2000 and December 2019. After systematic database screening of 2,893 articles, 60 PPS met the inclusion criteria and consequently were incorporated in this systematic review. Expert opinion: This review highlighted that most of the PPS were conducted in upper-middle and high-income countries. Prevalence of antimicrobial use was significantly higher in non-European hospitals compared with European hospitals. The domination of third-generation cephalosporin and fluoroquinolones use across all the regions suggests substantial use of broad-spectrum antimicrobials across countries. Among all identified regions around the world, India was the region where the highest use of antimicrobials was observed. Although PPS is a useful tool to assess the pattern of antimicrobial use and provides a robust baseline; however, a standardized surveillance method is needed. In order to optimize antimicrobial use, more efforts are required to improve antimicrobial use.

Matched MeSH terms: Fluoroquinolones
Occurrence and antibiotic resistance of Campylobacter jejuni and Campylobacter coli in retail broiler chicken

Usha, M.R., Fauziah, M., Tunung, R., Chai, L.C., Cheah, Y.K., Farinazleen, M.G., et al.

International Food Research Journal, 2010;17(2):247-255.
MyJurnal

Broiler part samples (80 fresh and 80 chilled) were examined for the prevalence and numbers of C. jejuni and C. coli by employing most-probable-number (MPN) and polymerase chain reaction (PCR) techniques. The prevalence of the bacteria was high where C. jejuni was detected in 92.5% fresh and 53.8% chilled samples while C. coli in 80.0% fresh and 56.3% chilled. The number of these bacteria in the positive fresh and chilled samples was from 3 to more than 2400 MPN/g and from 3 to 290 MPN/g, respectively. Antibiotic resistance test (using Kirby-Bauer disc diffusion method) on 10 C. jejuni and 13 C. coli isolates toward ampicillin, tobramycin, enrofloxacin, ciprofloxacin, tetracycline, cephalothin, gentamicin and norfloxacin revealed high resistance toward all antibiotics (20.0% - 100.0%). All isolates were resistant to at least two antibiotics. This study highlights the potential of multidrug-resistant C. jejuni and C. coli transmission to humans through fresh and chilled broiler parts. Consecutive studies with bigger sample sizes and covering all over Malaysia are warranted in future.

Matched MeSH terms: Fluoroquinolones
Fulltext Biosafety of Campylobacter jejuni from raw vegetables consumed as ulam with reference to their resistance to antibiotics

Chai, L.C., Fatimah, A.B., Ghazali, F.M., Lee, H.Y., Tunung, R., Shamsinar, A.T., et al.

International Food Research Journal, 2008;15(2):125-134.
MyJurnal

Antibiotic resistance in campylobacter is an emerging global public health problem after MRSA and VRE. Fluoroquinolone and macrolide resistance have been found to be more common in this world leading foodborne pathogen. A total of fifty-six isolates of Campylobacter jejuni obtained from raw vegetables
which are consumed as ulam (salad) in Malaysia, were tested with 12 antibiotics used clinically and
agriculturally. The resistance was determined using the disk diffusion method. Results were determined
by hierarchic numerical methods to cluster strains and antibiotics according to similarity profiles. Fifty
five C. jejuni isolates from different isolation sites were all clustered together into ten groups. This indicates that the commodities (raw salad vegetables/ulam) where the isolates originated might share a similar source of cross-contamination along the production route. All antibiotics tested correlated and there were four groupings reflecting their mode of actions. Generally, C. jejuni isolates were found to be highly resistant to erythromycin (91.1%) and tetracycline (85.7%). Both agents are popular antibiotics used clinically to treat bacterial infections. On the other hand, the C. jejuni isolates showed high percentage (80.4%) of resistance towards enrofloxacin, an extensively used antimicrobial agent in agriculture practices. This study showed that C. jejuni isolates were highly multi-resistance to as many as 10 antibiotics. Therefore, in terms of biosafety, the presence of antibiotic resistance strains in the food chain has raised concerns that the treatment of human infections will be compromised.

Matched MeSH terms: Fluoroquinolones
Fulltext Characterization of Edwardsiella tarda isolated from Asian Seabass, Lates calcarifer

Nadirah, M., Najiah M., Teng, S. Y.

International Food Research Journal, 2012;19(3):1247-1252.
MyJurnal

This study described the antibiotic and heavy metal resistance pattern of 17 isolates of Edwardsiella tarda obtained from Asian seabass (Lates calcarifer). E.tarda isolates were resistant to oleandomycin, lincomycin, novobiocin and spiramycin. In contrast, most of the isolates showed high level of susceptibility to tetracycline, doxycycline, florfenicol, chloramplenicol, nitrofurantoin, fosfomycin, kanamycin, oxolinic acid and flumequine. MAR value was 0.35 which indicated that the cultured Asian seabass have received high exposure to those tested antibiotics. Besides, very high level of heavy metal resistance among these isolates was observed. Genotypic profile of DNA fingerprintings generated by RAPD-PCR using M13 universal primer and M13 wild type phage primer showed high degree of genetic diversity with percentages similarity and genetic distance among the isolates were ranging from 10.5% to 100% and 0 to 0.895, respectively. This result indicates that strains that belong to the same origin were not always closely related genetically.

Matched MeSH terms: Fluoroquinolones
Fulltext Pneumonia and concurrent eggs retention in a river terrapin (Batagur baska)

Inirah, C.I., Donny, Y., Azlan, C.A., Teoh, H.X., Jesse, F.F.A.

Jurnal Veterinar Malaysia, 2017;29(1):13-17.
MyJurnal

A case report of pneumonia and egg retention in a river terrapin was presented in this paper. A 20 year-old river terrapin (Batagur baska) was presented with complaint of coughing with blood discharge, wheezing breathing and inappetance. Plain radiograph showed both right and left lung lobes were consolidated due to pneumonia 90% and 70%, respectively. Tentative diagnosis of pneumonia due to opportunistic bacterial infection of Chromobacterium sp. and Plesiomonas shigelloides was made in this case based on bacterial isolation and response to antibiotic and antiinflammatory drugs. Enrofloxacin and flunixin meglumine were administered from Day-1 to -5. Enrofloxacin was then changed to gentamicin since it showed resistance in those bacteria. No clinical changes were observed. Gentamicin was given at rate 2.5 mg/kg once a week intramuscularly and prednisolone 2 mg/kg once on Day-6 given intramuscularly, showed a response on Day-10 of hospitalisation with the evidence of reduction in lung consolidation by almost 90% clear of lung lobes from pneumonia. Sixteen thin-shelled eggs were also observed in the coelomic cavity on radiographic images. Active laying season, prolonged laying period and the history of laying only two eggs a week before presenting to hospital gives a highly suggestive diagnosis of egg retention syndrome. To encourage laying, the terrapin was given a daily parenteral calcium supplement, oxytocin 5 IU/kg intramuscularly (Day-10 hospitalisation) and was released for sunbath and to sand twice daily. The eggs were completely laid on Day-11 and the overall terrapin condition was greatly improved 2 weeks post-hospitalisation.

Matched MeSH terms: Fluoroquinolones
Fulltext Clinical and Antibacterial Effects of Tualang Honey on Pseudomonas-induced Keratitis in Rabbit Eyes

Punitan R, Sulaiman SA, Hasan HB, Shatriah I

Cureus, 2019 Mar 27;11(3):e4332.
PMID: 31186997 DOI: 10.7759/cureus.4332

Introduction Pseudomonas aeruginosa is a common cause of microbial keratitis that can cause a significant loss of visual acuity. Antibiotics, including fluoroquinolones and aminoglycosides, are clinically effective against Pseudomonas-induced keratitis, but their effectiveness has been conspicuously reduced as resistant pathogens have become more potent. This study sought to evaluate the clinical and antibacterial effects of tualang honey as an alternative therapeutic agent against Pseudomonas-induced keratitis. Methods We conducted a randomized control trial in which 30 rabbits were injected intrastromally with 1,000 colony-forming units (CFU) of Pseudomonas aeruginosa in the right eye of each rabbit (n = 30). The rabbits were then randomized into three groups of 10 rabbits each. Group A was treated with topical gentamicin 0.3%, group B was treated with topical tualang honey 30%, and group C received both treatments. The specified treatments were administered every two hours from 24 to 48 hours post injection, and subsequently every four hours for six days. Clinical examinations were performed on days one, two, three, five, and seven, and the mean results of slit lamp examinations (SLEs) were documented. On day seven after pseudomonas induction, the rabbits were euthanized and their corneas were harvested to determine the median CFU per cornea. Results There were no statistically significant differences (p > 0.05) in mean SLE scores (p = 0.209) or median CFU values (p = 0.820) between the three groups. Conclusion Topical gentamicin, topical tualang honey, and the combination of the two all showed similar clinical and antimicrobial effects in treating Pseudomonas-induced keratitis in rabbits. These findings should be verified in further studies with larger sample sizes and the addition of a control group.

Matched MeSH terms: Fluoroquinolones
Trends in the antibiotic resistance patterns of enteric Fever isolates - a three year report from a tertiary care centre

Gupta V, Singla N, Bansal N, Kaistha N, Chander J

Malays J Med Sci, 2013 Jul;20(4):71-5.
PMID: 24043999

BACKGROUND: The incidence of multidrug resistant enteric fever is increasing alarmingly. This study was planned to determine the rate of isolation of Salmonella spp. and to compare the isolates for their epidemiological parameters and antimicrobial susceptibility patterns at our center.
METHODS: The study was conducted over a span of three years with a total of 8142, 8134, and 8114 blood culture samples processed for the years 2008, 2009, and 2010 respectively. The minimum inhibitory concentration (MIC) for ciprofloxacin and chloramphenicol was determined using an agar dilution method. The MIC for ciprofloxacin was also confirmed by Epsilon-test (E -test) strips.
RESULTS: Of the total 302 Salmonella spp. isolated, 257 were Salmonella enterica serotype Typhi (85.1%) and 45 (14.9%) were S. enterica serotype Paratyphi A. The majority of the isolates recovered were from the pediatric age group (54.6%) and males (60.6%). Complete susceptibility was observed to chloramphenicol, cefotaxime, ceftriaxone, and azithromycin over the last two years (2009 and 2010), with an increase in resistance to nalidixic acid (100%) and ciprofloxacin (13.6%).
CONCLUSION: In our study, we found augmentation of resistance to nalidixic acid and fluoroquinolones and complete sensitivity to ceftriaxone along with reemergence of chloramphenicol sensitivity for Salmonella isolates. This report emphasises the necessity of continuous surveillance of antibiograms of enteric fever isolates in an area.

Matched MeSH terms: Fluoroquinolones
Genomic Insights into Two Colistin-Resistant Klebsiella pneumoniae Strains Isolated from the Stool of Preterm Neonate During the First Week of Life

Yap PSX, Ahmad Kamar A, Chong CW, Ngoi ST, Teh CSJ

Microb Drug Resist, 2020 Mar;26(3):190-203.
PMID: 31545116 DOI: 10.1089/mdr.2019.0199

Background:
Klebsiella pneumoniae is a major opportunistic pathogen frequently associated with nosocomial infections, and often poses a major threat to immunocompromised patients. In our previous study, two K. pneumoniae (K36 and B13), which displayed resistance to almost all major antibiotics, including colistin, were isolated. Both isolates were not associated with infection and isolated from the stools of two preterm neonates admitted to the neonatal intensive care unit (NICU) during their first week of life.
Materials and Methods:
In this study, whole genome sequencing was performed on these two clinical multidrug resistant K. pneumoniae. We aimed to determine the genetic factors that underline the antibiotic-resistance phenotypes of these isolates.
Results:
The strains harbored blaSHV-27, blaSHV-71, and oqxAB genes conferring resistance to cephalosporins, carbapenems, and fluoroquinolones, respectively, but not harboring any known plasmid-borne colistin resistance determinants such as mcr-1. However, genome analysis discovered interruption of mgrB gene by insertion sequences gaining insight into the development of colistin resistance.
Conclusion:
The observed finding that points to a scenario of potential gut-associated resistance genes to Gram negative (K. pneumoniae) host in the NICU environment warrants attention and further investigation.

Matched MeSH terms: Fluoroquinolones/pharmacology
Fulltext Correlation between antibiotic consumption and the occurrence of multidrug-resistant organisms in a Malaysian tertiary hospital: a 3-year observational study

Tan SY, Khan RA, Khalid KE, Chong CW, Bakhtiar A

Sci Rep, 2022 Feb 24;12(1):3106.
PMID: 35210515 DOI: 10.1038/s41598-022-07142-2

Inappropriate use of antibiotics has been shown to contribute to the occurrence of multidrug-resistant organisms (MROs). A surveillance study was performed in the largest tertiary care hospital in Kuala Lumpur, Malaysia, from 2018 to 2020 to observe the trends of broad-spectrum antibiotics (beta-lactam/beta-lactamases inhibitors (BL/BLI), extended-spectrum cephalosporins (ESC), and fluoroquinolones (FQ)) and antibiotics against MRO (carbapenems, polymyxins, and glycopeptides) usage and the correlation between antibiotic consumption and MROs. The correlation between 3-year trends of antibiotic consumption (defined daily dose (DDD)/100 admissions) with MRO infection cases (per 100 admissions) was determined using a Jonckheere-Terpstra test and a Pearson's Correlation coefficient. The antimicrobial resistance trend demonstrated a positive correlation between ESC and FQ towards the development of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp, ESBL-producing Escherichia coli (E. coli), and MRO Acinetobacter baumannii (A. baumannii). Increasing carbapenem consumption was positively correlated with the occurrence of ESBL-producing Klebsiella spp and E. coli. Polymyxin use was positively correlated with ESBL-producing Klebsiella spp, MRO A. baumannii, and carbapenem-resistant Enterobacteriaceae. The findings reinforced concerns regarding the association between MRO development, especially with a surge in ESC and FQ consumption. Stricter use of antimicrobials is thus crucial to minimise the risk of emerging resistant organisms.

Matched MeSH terms: Fluoroquinolones/pharmacology
Fulltext Moxifloxacin-warfarin interaction

Yew KL, Lee WC

Med J Malaysia, 2012 Aug;67(4):420-1.
PMID: 23082454 MyJurnal
Matched MeSH terms: Fluoroquinolones
Fulltext In-vitro activity of quinupristin/dalfopristin, levofloxacin and moxifloxacin against fusidic acid and rifampicin-resistant strains of methicillin-resistant Staphylococcus aureus (MRSA) from Malaysian hospitals

Norazah A, Lim VKE, Rohani MY, Kamel AGM

Med J Malaysia, 2005 Oct;60(4):411-5.
PMID: 16570701

The in-vitro susceptibility of quinupristin/dalfopristin, levofloxacin and moxifloxacin against methicillin-resistant Staphylococcus aureus (MRSA) strains, which are also resistant to fusidic acid and rifampicin were carried out to determine whether these antibiotics can be used as an alternative treatment for multiply resistant MRSA strains. The minimum inhibitory concentrations (MIC) of these antibiotics were determined by E-test. Quinupristin/dalfopristin had good activity (MIC90 = 1 mg/L) against these strains while most of the strains showed intermediate resistance to moxifloxacin with MIC90 = 2 mg/L). However, more than 90% of these strains were resistant to levofloxacin with the MICs that ranged from 8 mg/L to 16 mg/L with the majority inhibited at 8 mg/L.

Matched MeSH terms: Fluoroquinolones

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