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Journal of Antimicrobial Chemotherapy (2001) 48, 653-658
© 2001 The British Society for Antimicrobial Chemotherapy

In vitro antimicrobial susceptibility of Aerococcus urinae to 14 antibiotics, and time–kill curves for penicillin, gentamicin and vancomycin

Robert Skova,*, Jens Jørgen Christensenb, Bent Kornerc, Niels Frimodt-Møllerb and Frank Espersena

a Departments of Research and Development and b Clinical Microbiology, Statens Serum Institut, Copenhagen; c Department of Clinical Microbiology, Bispebjerg Hospital, Copenhagen, Denmark

Aerococcus urinae is a newcomer in clinical and microbiological practice, causing urinary tract infections, bacteraemia/septicaemia and/or endocarditis. This study presents for the first time an evaluation of the activity of a representative panel of antibiotics against a large number of A. urinae isolates. The in vitro susceptibilities (MICs) of 56 isolates of A. urinae to 14 antibiotics were determined by agar dilution. In general, A. urinae isolates showed little inter-isolate variability, and had low MICs of penicillin, amoxicillin, piperacillin, cefepime, vancomycin and rifampicin. High-level aminoglycoside resistance was not found for any of the isolates. Moderate to good activity was seen with quinolones, erythromycin and tetracycline. Isolates from two patients with endocarditis were studied with time–kill curves for penicillin, gentamicin and vancomycin. Penicillin and vancomycin alone exhibited slow or no bactericidal activity against the two strains. When combining either penicillin or vancomycin with gentamicin, rapid bactericidal activity was obtained for both strains with both combinations. The treatment options for A. urinae seem to include penicillins for less severe cases. In severe cases, i.e. endocarditis, the time–kill investigations suggest a beneficial effect of combination with gentamicin. In the penicillin-allergic patient vancomycin in combination with gentamicin represents the most obvious alternative.

* Correspondence address. Department of Research and Development, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark. Tel: +45-3268-3535; Fax: +45-3268-3873; E-mail: rsk{at}ssi.dk


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