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JAC Advance Access originally published online on September 20, 2002
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Journal of Antimicrobial Chemotherapy (2002) 50, 731-734
© 2002 The British Society for Antimicrobial Chemotherapy

Nisin, alone and combined with peptidoglycan-modulating antibiotics: activity against methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci

W. Brumfitt1, M. R. J. Salton2 and J. M. T. Hamilton-Miller1,*

1 Department of Medical Microbiology, Royal Free and University College Medical School, London NW3 2PF, UK; 2 Department of Microbiology, New York University School of Medicine, New York, NY, USA

Received 14 March 2002; returned 2 May 2002; revised 29 July 2002; accepted 31 July 2002

Objective: We have sought ways to circumvent resistance, by combining nisin with other antibiotics known to target bacterial cell wall biosynthesis.

Methods: Twenty strains each of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) were tested in vitro by standardized methods against nisin alone and combined with bacitracin, ramoplanin and chloramphenicol.

Results: Ramoplanin was the most potent compound, and bacitracin had the least activity. Two-way synergy was observed with nisin and ramoplanin. However, chloramphenicol was clearly antagonistic to the activity of nisin.

Conclusions: Observations of synergy between nisin and ramoplanin against MRSA and VRE offer a promising approach to the concept of combining nisin with inhibitors of cell wall peptidoglycan. Further investigations are needed in order to develop this approach as a clinical possibility.

* Corresponding author. Tel: +44-20-779-40500; Fax: +44-20-7435-9694; E-mail: j.hamilton-miller{at}rfc.ucl.ac.uk


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