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Journal of Antimicrobial Chemotherapy (1996) 37, 243-251
© 1996 The British Society for Antimicrobial Chemotherapy

research-article

In-vitro susceptibility of isolates of methicillin-resistant Staphylococcus aureus 1988–1993

O. Scheela, D. J. Lyona, V. T. Rosdahlb, F. A. B. Adeyemi-Doroa, T. K. W. Linga and A. F. B. Chenga

aDepartment of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong Shatin, N.T., Hong Kong bStatens Seruminstitut, Artillerivej 5, 2300 Copenhagen S, Denmark

Received 12 April 1995; returned 24 July 1995; accepted 8 September 1995

MICs for 423 strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated in Hong Kong during 1988–1993 were performed for 15 antimicrobial agents: erythromycin, chloramphenicol, tetracycline, minocycline, gentamicin, netilmicin, trimethoprim, rifampicin, fusidic acid, ciprofloxacin, vancomycin, teicoplanin, sparfloxacin, clinafloxacin and RP 59500 (quinupristin/dalfopristin). Susceptibility to antibiotics generally remained stable throughout the study period, with the exception of the quinolones. Resistance to ciprofloxacin (breakpoint 4 mg/L) increased from a low of 9% in 1988 to a high of 82% in 1993. For sparfloxacin the corresponding figures were 9% and 78%, respectively. Six (1%) clinafloxacin-resistant strains were found. MIC50s and MIC90s of clinafloxacin increased from ≤0.06 mg/L and 0.25 mg/L in 1988 to 1.0 mg/L and 2.0 mg/L, respectively, in 1993. All 423 strains were phage typed (typability 70%) and a diversity of phage types which changed during the observation period, with 13 dominating types, was observed. Ciprofloxacin resistance occurred in 12 of the dominating types, in 46 non-typable strains, and also in 23 strains of different, sporadically occurring types, indicating that the emergence of quinolone resistance was not due to dissemination of a single or few MRSA clones. The usefulness of quinolones in the treatment of MRSA infections is likely to be seriously constrained by the emergence of resistance. MICs for RP-595OO were ≤ 2 mg/L for all isolates, suggesting that this agent merits further evaluation as an anti-MRSA agent. All MRSA remained susceptible to vancomycin and teicoplanin throughout the study period.


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