Prevalence of Teicoplanin-resistant Staphylococci and Evaluation of the Disk Diffusion Test for Testing the Susceptibility of Staphylococci to Teicoplanin

Kim, Myungshin; Park, Yeon Joon; Kim, Byung Kee; Kim, Sun Moo; Shim, Sang In

Abstract

BACKGROUND
Teicoplanin is a glycopeptide antimicrobial agent effective against methicillin-resistant staphylococci. Decreased susceptibility of staphylococci to glycopeptides has been increasing. Teicoplanin diffuses poorly in agar and therefore the correlation between the inhibition zone diameter and the minimal inhibitory concentration(MIC) is rather poor. The purpose of this study was to evaluate the prevalence of teicoplanin-resistant staphylococci and to assess the reliability of inhibition zone diameters for determining the susceptibility of staphylococci to teicoplanin by comparing the results of the agar dilution MICs.
METHODS
From June to August 1997, 290 clinical isolates of staphylococci(77 coagulase negative staphylococci(CNS), 213 Staphylococcus aureus) were collected. The antimicrobial susceptibilities to teicoplanin were determined by inhibition zone diameter and the results were compared with the MICs determined by the agar dilution method.
RESULTS
Among 77 CNS strains, 75(97.4%) were susceptible and 2(2.6%) were intermediate by agar dilution method and all 213 strains of S. aureus were susceptible to teicoplanin. There was a poor correlation(r=0.50) between the zone diameters of inhibition and agar dilution MICs. In comparison with the results of disk diffusion test and agar dilution MIC, eight (2.8%) out of 290 isolates showed discrepancies (major error rates : 0.3%, minor error rates: 2.4%).
CONCLUSIONS
Two(2.6%) out of 77 strains of CNS and none of 213 S. aureus strains revealed decreased susceptibility to teicoplanin. And the inhibition zone diameter was less reliable in determining the susceptibility of staphylococci than MICs. Therefore, the more effective and convenient method is needed.