Dichotomous selection of high-level oxacillin resistance in Staphylococcus aureus by fluoroquinolones

International Journal of Antimicrobial Agents
Axel Dalhoff, Sabine Schubert

Abstract

The objective of this study was to determine whether exposure of Staphylococcus aureus to early (ciprofloxacin or levofloxacin) and a recent fluoroquinolone (moxifloxacin) has differential potential as a mutator or selector for meticillin resistance. The potential of fluoroquinolones to act as mutators or selectors was studied in 24 strains each of healthcare-associated meticillin-susceptible S. aureus (MSSA) and meticillin-resistant S. aureus (MRSA) as well as 6 strains of community-acquired MRSA. Mutator or selector potential was studied first by exposing isolates to 0.5x the fluoroquinolone minimal inhibitory concentration (MIC) and screening for either single-step fluoroquinolone resistance or high-level oxacillin resistance; second, by exposing the heteroresistant MRSA P8 parent strain as well as fluoroquinolone-resistant subpopulations derived from strain P8 to constant fluoroquinolone concentrations ranging from 0.015 mg/L to 128 mg/L; and third, by exposing the heteroresistant MRSA population of strain P8 to fluctuating concentrations of ciprofloxacin, levofloxacin and moxifloxacin simulating oral doses of 500 mg twice a day, 500 mg once daily (qd) and 400mg qd, respectively, compared with amoxicillin/clavulanic acid 50...Continue Reading

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Citations

Oct 26, 2012·Interdisciplinary Perspectives on Infectious Diseases·Axel Dalhoff
Nov 1, 2011·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Karl J Madaras-KellyKevin L Sloan
Jul 2, 2011·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Christopher H Goss, Marianne S Muhlebach
Aug 4, 2018·Pediatric Pulmonology·Nour Akil, Marianne S Muhlebach

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