In vitro fluoroquinolone resistance in staphylococcal endophthalmitis isolates

Darlene Miller, Patrick M. Flynn, Ingrid U. Scott, Eduardo C Alfonso, Harry W Flynn

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

Objective: To evaluate the in vitro susceptibility and cross-resistance of gatifloxacin and moxifloxacin vs older fluoroquinolones among coagulase-negative staphylococci recovered from patients with clinical endophthalmitis. Methods: A combination of E tests and disk diffusion methods was used to determine in vitro susceptibility and cross-resistance for 111 coagulase-negative staphylococci isolates recovered during a 15-year period (January 1, 1990, to December 31, 2004) against 5 fluoroquinolones. Results: In vitro susceptibilities (percentage sensitive) in descending order were as follows: gatifloxacin, 74.5%; moxifloxacin, 72.1%; levofloxacin, 69.3%; ciprofloxacin, 65.6%, and ofloxacin, 60.4%. More than 65% of the coagulase-negative staphylococci resistant to ciprofloxacin (n = 38) demonstrated in vitro cross-resistance to gatifloxacin (25 [65.8%] of 38) and moxifloxacin (27 [71.1%] of 38). During the initial 5 years (January 1, 1990, to December 31, 1994), 96.6% of the coagulase-negative staphylococci were sensitive to gatifloxacin and moxifloxacin, with minimal inhibitory concentration required to inhibit or kill 90% of the isolates of 0.19 μg/mL and 0.12 μg/mL, respectively. During the last 5-year period (January 1, 2000, to December 31, 2004), the percentage of sensitive coagulase-negative staphylococci declined to 65.4% for gatifloxacin and moxifloxacin (P=. 02). Minimal inhibitory concentration required to inhibit or kill 90% of the isolates was 32 μg/mL or greater for both drugs. Conclusions: Gatifloxacin and moxifloxacin demonstrated an in vitro efficacy of less than 80% for coagulase-negative staphylococci endophthalmitis in the present study. Ciprofloxacin resistance may serve as a surrogate for concurrent in vitro resistance for gatifloxacin and moxifloxacin. Resistence increased significantly during the last 5 years. Declining in vitro susceptibility to gatifloxacin and moxifloxacin may have important implications for the prevention and treatment of postoperative endophthalmitis.

Original languageEnglish
Pages (from-to)479-483
Number of pages5
JournalArchives of Ophthalmology
Volume124
Issue number4
DOIs
StatePublished - Apr 26 2006

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Endophthalmitis
Fluoroquinolones
Coagulase
Staphylococcus
Ciprofloxacin
Levofloxacin
Ofloxacin
gatifloxacin
moxifloxacin
In Vitro Techniques

ASJC Scopus subject areas

  • Ophthalmology

Cite this

In vitro fluoroquinolone resistance in staphylococcal endophthalmitis isolates. / Miller, Darlene; Flynn, Patrick M.; Scott, Ingrid U.; Alfonso, Eduardo C; Flynn, Harry W.

In: Archives of Ophthalmology, Vol. 124, No. 4, 26.04.2006, p. 479-483.

Research output: Contribution to journalArticle

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abstract = "Objective: To evaluate the in vitro susceptibility and cross-resistance of gatifloxacin and moxifloxacin vs older fluoroquinolones among coagulase-negative staphylococci recovered from patients with clinical endophthalmitis. Methods: A combination of E tests and disk diffusion methods was used to determine in vitro susceptibility and cross-resistance for 111 coagulase-negative staphylococci isolates recovered during a 15-year period (January 1, 1990, to December 31, 2004) against 5 fluoroquinolones. Results: In vitro susceptibilities (percentage sensitive) in descending order were as follows: gatifloxacin, 74.5{\%}; moxifloxacin, 72.1{\%}; levofloxacin, 69.3{\%}; ciprofloxacin, 65.6{\%}, and ofloxacin, 60.4{\%}. More than 65{\%} of the coagulase-negative staphylococci resistant to ciprofloxacin (n = 38) demonstrated in vitro cross-resistance to gatifloxacin (25 [65.8{\%}] of 38) and moxifloxacin (27 [71.1{\%}] of 38). During the initial 5 years (January 1, 1990, to December 31, 1994), 96.6{\%} of the coagulase-negative staphylococci were sensitive to gatifloxacin and moxifloxacin, with minimal inhibitory concentration required to inhibit or kill 90{\%} of the isolates of 0.19 μg/mL and 0.12 μg/mL, respectively. During the last 5-year period (January 1, 2000, to December 31, 2004), the percentage of sensitive coagulase-negative staphylococci declined to 65.4{\%} for gatifloxacin and moxifloxacin (P=. 02). Minimal inhibitory concentration required to inhibit or kill 90{\%} of the isolates was 32 μg/mL or greater for both drugs. Conclusions: Gatifloxacin and moxifloxacin demonstrated an in vitro efficacy of less than 80{\%} for coagulase-negative staphylococci endophthalmitis in the present study. Ciprofloxacin resistance may serve as a surrogate for concurrent in vitro resistance for gatifloxacin and moxifloxacin. Resistence increased significantly during the last 5 years. Declining in vitro susceptibility to gatifloxacin and moxifloxacin may have important implications for the prevention and treatment of postoperative endophthalmitis.",
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AU - Flynn, Harry W

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N2 - Objective: To evaluate the in vitro susceptibility and cross-resistance of gatifloxacin and moxifloxacin vs older fluoroquinolones among coagulase-negative staphylococci recovered from patients with clinical endophthalmitis. Methods: A combination of E tests and disk diffusion methods was used to determine in vitro susceptibility and cross-resistance for 111 coagulase-negative staphylococci isolates recovered during a 15-year period (January 1, 1990, to December 31, 2004) against 5 fluoroquinolones. Results: In vitro susceptibilities (percentage sensitive) in descending order were as follows: gatifloxacin, 74.5%; moxifloxacin, 72.1%; levofloxacin, 69.3%; ciprofloxacin, 65.6%, and ofloxacin, 60.4%. More than 65% of the coagulase-negative staphylococci resistant to ciprofloxacin (n = 38) demonstrated in vitro cross-resistance to gatifloxacin (25 [65.8%] of 38) and moxifloxacin (27 [71.1%] of 38). During the initial 5 years (January 1, 1990, to December 31, 1994), 96.6% of the coagulase-negative staphylococci were sensitive to gatifloxacin and moxifloxacin, with minimal inhibitory concentration required to inhibit or kill 90% of the isolates of 0.19 μg/mL and 0.12 μg/mL, respectively. During the last 5-year period (January 1, 2000, to December 31, 2004), the percentage of sensitive coagulase-negative staphylococci declined to 65.4% for gatifloxacin and moxifloxacin (P=. 02). Minimal inhibitory concentration required to inhibit or kill 90% of the isolates was 32 μg/mL or greater for both drugs. Conclusions: Gatifloxacin and moxifloxacin demonstrated an in vitro efficacy of less than 80% for coagulase-negative staphylococci endophthalmitis in the present study. Ciprofloxacin resistance may serve as a surrogate for concurrent in vitro resistance for gatifloxacin and moxifloxacin. Resistence increased significantly during the last 5 years. Declining in vitro susceptibility to gatifloxacin and moxifloxacin may have important implications for the prevention and treatment of postoperative endophthalmitis.

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