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Journal of Antimicrobial Chemotherapy (1992) 30, 821-826
© 1992 The British Society for Antimicrobial Chemotherapy

research-article

Development of new antibiotic resistance in methicillin-resistant but not methicillin-susceptible Staphylococcus aureus

Sandra J. Wadswortha, Ki-Ho Kima, Vilas Satishchandranb, Peter Axelroda, Allan L. Truantb,c and Byungse Suha,

Section of Infectious Diseases aDepartments of Medicine Philadelphia, Pennsylvania 19140, USA bDepartments of Clinical Microbiology Laboratory, Temple University Hospital Philadelphia, Pennsylvania 19140, USA cDepartments of Microbiology and Immunology, Temple University School of Medicine Philadelphia, Pennsylvania 19140, USA

Received 1 April 1992; returned 27 July 1992; accepted 27 July 1992

Correspondence to: Dr Byungse Suh, Section of Infectious Diseases, Temple University Health Sciences Center, Broad and Ontario Streets, Philadelphia, PA 19140, USA

The frequency of infections caused by multidrug-resistant Staphylococcus aureus continues to increase while the numbers of alternative therapeutic agents remain limited. To investigate the changing patterns of in-vitro susceptibility of S. aureus to 16 antibiotics, 190 clinical isolates from two different years were studied. The MICs of methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains isolated in 1987 were compared with those of similar numbers of strains isolated in 1989. For MRSA ≥90% of isolates from both years were resistant to clindamycin, gentamicin and erythromycin. These strains remained highly susceptible to vancomycin (100%), minocycline (90%) and rifampicin (100%). The greatest increase in resistance was observed for ofloxacin (2% in 1987 vs 62% in 1989); cross-resistance to all of the quinolones tested was demonstrated. MSSA strains remained susceptible to vancomycin (100%), minocycline (98%), rifampicin (100%), clindamycin (90%), gentamicin (90%) and ciprofloxacin (98%). It is concluded that methicillin susceptibility is a useful marker for selecting potential agents for the treatment of infections caused by S. aureus. A combination of minocydine and rifampicin may be a useful alternative to vancomycin for treating MRSA infections.


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