Selection of rifampicin-resistant Staphylococcus aureus during tuberculosis therapy: concurrent bacterial eradication and acquisition of resistance

The Journal of Antimicrobial Chemotherapy
Youning LiuXilin Zhao

Abstract

Acquired antimicrobial resistance is commonly attributed to regimens that expose bacteria to subinhibitory concentrations; consequently, eradication of susceptible cells is advocated. The mutant selection window hypothesis predicts that resistance can be acquired even when inhibitory concentrations are exceeded and susceptible bacteria are eradicated. The objective was to test that prediction clinically. Tuberculosis patients (n = 372) were sampled for nasal colonization by Staphylococcus aureus at the beginning of anti-tuberculosis therapy with rifampicin-containing regimens and again after 2 and 4 weeks. Rifampicin susceptibility of S. aureus was determined, and S. aureus isolates from patients developing acquired resistance were examined by molecular strain typing. Diabetes patients (n = 200) served as untreated controls. Nasal colonization was 17% and 20% for the tuberculosis and diabetes patients, respectively. Four patients were initially colonized with rifampicin-resistant S. aureus and were excluded from further sampling. Initiation of anti-tuberculosis therapy eradicated S. aureus nasal colonization in 53/58 tuberculosis patients while allowing acquisition of rifampicin resistance in 5/58. Pulsed-field gel electrophore...Continue Reading

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Citations

Feb 6, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Karl Drlica, Xilin Zhao
Jun 12, 2008·The Journal of Antimicrobial Chemotherapy·Xilin Zhao, Karl Drlica
Sep 4, 2008·Antimicrobial Agents and Chemotherapy·Nadezhda GermanRobert J Kerns
Apr 20, 2013·Journal of Global Infectious Diseases·Gopalakrishnan ManigandanPalanisamy Soundararajan
Dec 3, 2013·Acta Microbiologica Et Immunologica Hungarica·József KlemGábor Rákhely
May 14, 2016·Journal of Children's Orthopaedics·Vasiliki SpyropoulouDimitri Ceroni
Jul 2, 2014·Clinical Microbiology Reviews·Yvonne AchermannMark E Shirtliff
Dec 5, 2019·Expert Review of Anti-infective Therapy·Korakrit ImwattanaThomas V Riley
Jan 15, 2015·Journal of Veterinary Internal Medicine·D M RhodesS J Spier

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