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      Persistence of Resistant Staphylococcus epidermidis after Single Course of Clarithromycin

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          Abstract

          Short course of antimicrobial therapy can select resistant bacteria that persist for 4 years or longer.

          Abstract

          We examined how a common therapy that includes clarithromycin affects normally colonizing Staphylococcus epidermidis. Samples from the nostrils of 5 patients receiving therapy were collected before, immediately after, 1 year after, and 4 years after treatment. From each patient and sample, S. epidermidis strains were isolated and analyzed for clarithromycin susceptibility and presence of the erm(C) gene. We show that macrolide-resistant strains of S. epidermidis were selected during therapy and that the same resistant strain may persist for 4 years, in the absence of further antimicrobial treatment.

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          The biological cost of antibiotic resistance.

          Dan Andersson, Bruce R. Levin (1999)
          The frequency and rates of ascent and dissemination of antibiotic resistance in bacterial populations are anticipated to be directly related to the volume of antibiotic use and inversely related to the cost that resistance imposes on the fitness of bacteria. The data available from recent laboratory studies suggest that most, but not all, resistance-determining mutations and accessory elements engender some fitness cost, but those costs are likely to be ameliorated by subsequent evolution.
          Article 0 comments Cited 223 times – based on 0 reviews     Review now
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            Effect of antimicrobial agents on the ecological balance of human microflora.

            A. Sullivan, C Edlund, C E Nord (2001)
            The normal microflora acts as a barrier against colonisation of potentially pathogenic microorganisms and against overgrowth of already present opportunistic microorganisms. Control of growth of opportunistic microorganisms is termed colonisation resistance. Administration of antimicrobial agents, therapeutically or as prophylaxis, causes disturbances in the ecological balance between the host and the normal microflora. Most studies on the impact of antimicrobial agents on normal microflora have been carried out on the intestinal flora. Less is known on the effects on oropharyngeal, skin, and vaginal microflora. Disturbances in the microflora depend on the properties of the agents as well as of the absorption, route of elimination, and possible enzymatic inactivation and/or binding to faecal material of the agents. The clinically most common disturbances in the intestinal microflora are diarrhoea and fungal infections that usually cease after the end of treatment. A well-balanced microflora prevents establishment of resistant microbial strains. By using antimicrobial agents that do not disturb colonisation resistance, the risk of emergence and spread of resistant strains between patients and dissemination of resistant determinants between microorganisms is reduced. In this article, the potential ecological effects of administration of antimicrobial agents on the intestinal, oropharyngeal, and vaginal microflora are summarised. The review is based on clinical studies published during the past 10 years.
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              Pathogenesis of infections due to coagulase-negative staphylococci.

              Christof von Eiff, Georg Peters, Christine Heilmann (2002)
              As a group, the coagulase-negative staphylococci (CoNS) are among the most frequently isolated bacteria in the clinical microbiology laboratory and are becoming increasingly important, especially as causes of hospital-acquired infections. These bacteria are normal inhabitants of human skin and mucous membranes and, therefore, one of the major challenges of daily diagnostic work is to distinguish clinically significant CoNS from contaminant strains. This overview addresses current knowledge of the pathogenesis of infections due to CoNS and particularly focuses on virulence factors of the species Staphylococcus epidermidis. S epidermidis has been identified as a major cause of nosocomial infections, especially in patients with predisposing factors such as indwelling or implanted foreign polymer bodies. Most important in the pathogenesis of foreign-body-associated infections is the ability of these bacteria to colonise the polymer surface by the formation of a thick, multilayered biofilm. Biofilm formation takes place in two phases. The first phase involves the attachment of the bacteria to polymer surfaces that may be either unmodified or coated with host extracellular matrix proteins. In the second phase, the bacteria proliferate and accumulate into multilayered cell clusters that are embedded in an extracellular material. The bacterial factors involved in both phases of biofilm formation are discussed in this review. In addition, the most important aspects of the pathogenic potential of S saprophyticus, S lugdunensis, and S schleiferi are described, although, compared with S epidermidis, much less is known in these species concerning their virulence factors.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): September 2005
                Volume: 11
                Issue: 9
                Pages: 1389-1393
                Affiliations
                [* ]University Hospital, Uppsala, Sweden;
                [† ]The Swedish Institute for Infectious Disease Control, Solna, Sweden;
                [‡ ]New York University School of Medicine, New York, New York, USA
                Author notes
                Address for correspondence: Lars Engstrand, Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden; fax: 46-8-301-797; email: lars.engstrand@ 123456smi.ki.se
                Article
                Publisher ID: 05-0124
                DOI: 10.3201/eid1109.050124
                PMC ID: 3310621
                PubMed ID: 16229767
                SO-VID: 3c8eb87a-3ba6-4699-b1e7-dc51a87f4701
                History
                Categories
                Subject: Research
                Subject: Research

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: macrolides,staphylococcus epidermidis,clarithromycin,research,antimicrobial resistance
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: macrolides, staphylococcus epidermidis, clarithromycin, research, antimicrobial resistance

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