Novel combinations of vancomycin plus ceftaroline or oxacillin against methicillin-resistant vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA

Antimicrob Agents Chemother. 2013 May;57(5):2376-9. doi: 10.1128/AAC.02354-12. Epub 2013 Feb 19.

Abstract

We demonstrated a significant inverse correlation between vancomycin and beta-lactam susceptibilities in vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) isolates. Using time-kill assays, vancomycin plus oxacillin or ceftaroline was synergistic against 3 of 5 VISA and 1 of 5 hVISA isolates or 5 of 5 VISA and 4 of 5 hVISA isolates, respectively. Beta-lactam exposure reduced overall vancomycin-Bodipy (dipyrromethene boron difluoride [4,4-difluoro-4-bora-3a,4a-diaza-s-indacene] fluorescent dye) binding but may have improved vancomycin-cell wall interactions to improve vancomycin activity. Further research is warranted to elucidate the mechanism behind vancomycin and beta-lactam synergy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Boron Compounds
  • Ceftaroline
  • Cell Wall / drug effects
  • Cell Wall / metabolism
  • Cephalosporins / pharmacology*
  • Drug Combinations
  • Drug Synergism
  • Fluorescent Dyes
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / growth & development
  • Microbial Sensitivity Tests
  • Oxacillin / pharmacology*
  • Vancomycin / pharmacology*
  • Vancomycin Resistance / drug effects

Substances

  • 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene
  • Anti-Bacterial Agents
  • Boron Compounds
  • Cephalosporins
  • Drug Combinations
  • Fluorescent Dyes
  • Vancomycin
  • Oxacillin