Efficacy of vancomycin-beta-lactam combinations against heterogeneously vancomycin-resistant Staphylococcus aureus (hetero-VRSA)

J Korean Med Sci. 2003 Jun;18(3):319-24. doi: 10.3346/jkms.2003.18.3.319.

Abstract

There have been conflicting data about the interactions between vancomycin and beta-lactam agents against Staphylococcus aureus strains with heterogeneous resistance to vancomycin. We evaluated the efficacy of these combinations against Mu 3 and heterogeneously vancomycin-resistant S. aureus (hetero-VRSA) strains which were isolated from Korean patients using a population analysis method. Antagonistic effects were observed when less than 1 g/mL of beta-lactam antibiotics was combined with vancomycin, whereas synergistic effects were noticed with more than 4 microgram/mL of beta-lactam antibiotics. The antagonistic effects at low concentrations of beta-lactams were most prominent at 2 microgram/mL of vancomycin, which were the vancomycin MICs of tested hetero-VRSA strains. This study showed the variable effects of vancomycin- beta-lactam combinations depending on the concentrations of beta-lactam antibiotics and this property could be used to develop screening methods for hetero-VRSA strains.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Cefotaxime / pharmacology
  • Drug Synergism
  • Humans
  • In Vitro Techniques
  • Microbial Sensitivity Tests
  • Oxacillin / pharmacology*
  • Staphylococcus aureus / drug effects*
  • Vancomycin / pharmacology*
  • Vancomycin Resistance
  • beta-Lactam Resistance

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Cefotaxime
  • Oxacillin