Abstract
The development of resistance in vitro in five strains ofStreptococcus pneumoniae (3 with full susceptibility and 2 with intermediate susceptibility to penicillin) was investigated by serial passages in the presence of subinhibitory concentrations of amoxicillin and ampicillin. At the end of passaging, MICs of antibiotics for all the strains increased by a factor of four or more, reaching at least intermediate levels. MICs of cephalosporins, ampicillin and amoxicillin increased for almost all variants obtained. Similar results were obtained with amoxicillin plus clavulanic acid at a ratio of 2:1 and at a constant concentration of 2 µg/ml, and with ampicillin plus sulbactam at a ratio 2:1. In contrast, no significant modification of MIC was seen with ampicillin plus sulbactam at a constant concentration of 4 µg/ml sulbactam. These results suggest interaction of sulbactam with penicillin binding proteins as described previously for other bacterial species, and merit further investigation.
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References
Leedom JM Pneumonia. Patient profiles, choice of empiric therapy and the place of third generation cephalosporins. Diagnostic Microbiology and Infectious Disease 1992, 15: 57–66.
Appelbaum PC Antimicrobial resistance inStreptococcus pneumoniae: an overview. Clinical Infectious Diseases 1992, 15: 77–83.
Klugman KP Pneumococcal resistance to antibiotics. Clinical Microbiology Reviews 1990, 3: 171–196.
Casal J, Fenoll A History of the pneumococcal resistance in Spain. Médecine et Maladies Infectieuses 1992, 22, Supplement: 63–66.
Baquero F Streptococcus pneumoniae: étal actuel de la sensibilité aux antibiotiques en Espagne et relation avec la consommation d'antibiotiques. La Lettre de l'Infectiologue 1991, 6: 420–422.
Frank U, Schmidt-Eisenlohr, Joos-Württemberger A, Hasse J, Daschner F Concentrations of sulbactam/ampicillin in serum and lung tissue. Infection 1990, 5: 307–363.
Jehl F Acide clavulanique: concentrations efficaces, méthodologies analytiques et pénétration tissulaire. Médecine et Maladies Infectieuses 1993, 23, Supplement: 31–41.
Lorian V, Markovits G Disk test for the differentiation of pneumococci from other alpha-hemolytic streptococci. Applied Microbiology 1973, 26: 116–117.
Soares S, Kristinsson KG, Musser JM, Tomasz A Evidence for the introduction of a multiresistant clone of serotype 6BStreptococcus pneumoniae from Spain to Iceland in the late 1980s. Journal of Infectious Diseases 1993, 168: 158–163.
Mason EO, Kaplan SL, Lamberth LB, Tillman J Increased rate of isolation of penicillin-resistantStreptococcus pneumoniae in a children's hospital and in vitro susceptibilities to antibiotics of potential therapeutic use. Antimicrobial Agents and Chemotherapy 1992, 36: 1703–1707.
Reichler MR, Allphin AA, Breiman RF, Schreiber JR, Arnold JE, Mc Dougal LK, Facklam RR, Boxerbaum B, May D, Walton RO, Jacobs MK The spread of multiply resistantStreptococcus pneumoniae at a day care center in Ohio. Journal of Infectious Diseases 1992, 166: 1346–1353.
Ford KL, Mason EO, Kaplan SL, Lamberth LB, Tillman J Factors associated with middle ear isolates ofStreptococcus pneumoniae resistant to penicillin in a children's hospital. Journal of Pediatrics 1991, 119: 941–944.
Figueirido AM, Connor JD, Severin A, Vaz Pato MV, Tomasz A A pneumococcal clinical isolate with high-level resistance to cefotaxime and ceftriaxone. Antimicrobial Agents and Chemotherapy 1992, 36: 886–889.
Masson JM, Kazmierczak A, Labia R Interactions of clavulanic acid and sulbactam with penicillin-binding proteins. Drugs in Experimental Clinical Research 1983, 9: 513–518.
Handwerger S, Tomasz A Alterations in penicillin-binding proteins of clinical and laboratory isolates of pathogenicStreptococcus pneumoniae with low levels of penicillin resistance. Journal of Infectious Diseases 1986, 153: 83–89.
Chalkley LJ, Koornhof HJ Penicillin-binding proteins ofStreptococcus pneumoniae. Journal of Antimicrobial Chemotherapy 1988, 22: 791–800.
Kobayashi S, Arai S, Hayashi S In vitro effects of beta-lactamase inhibitors against methicillin resistantS. aureus. Antimicrobial Agents and Chemotherapy 1989, 33: 331–335.
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Carsenti-Etesse, H., Durant, J., De Salvador, F. et al. Possible prevention of in vitro selection of resistantStreptococcus pneumoniae by beta-lactamase inhibitors. Eur. J. Clin. Microbiol. Infect. Dis. 13, 1058–1062 (1994). https://doi.org/10.1007/BF02111828
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DOI: https://doi.org/10.1007/BF02111828