J Korean Med Sci.
2003 Jun;18(3):319-324. 10.3346/jkms.2003.18.3.319.
Efficacy of Vancomycin-beta-lactam Combinations Against Heterogeneously Vancomycin-Resistant Staphylococcus aureus (hetero-VRSA)
- Affiliations
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- 1Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
- 2Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. smkimkor@charter.net
- 3Department of Clinical Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Department of Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
- KMID: 2157644
- DOI: http://doi.org/10.3346/jkms.2003.18.3.319
Abstract
- There have been conflicting data about the interactions between vancomycin and beta-lactam agents against Staphylococcus aureus strains with heterogeneous resistance to vancomycin. We evaluated the efficacy of these combinations against Mu 3 and heterogeneously vancomycin-resistant S. aureus (hetero-VRSA) strains which were isolated from Korean patients using a population analysis method. Antagonistic effects were observed when less than 1 g/mL of beta-lactam antibiotics was combined with vancomycin, whereas synergistic effects were noticed with more than 4 microgram/mL of beta-lactam antibiotics. The antagonistic effects at low concentrations of beta-lactams were most prominent at 2 microgram/mL of vancomycin, which were the vancomycin MICs of tested hetero-VRSA strains. This study showed the variable effects of vancomycin- beta-lactam combinations depending on the concentrations of beta-lactam antibiotics and this property could be used to develop screening methods for hetero-VRSA strains.
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