[Sensitivity pattern of 117 clinical isolates of Staphylococcus aureus from 12 hospitals].
OBJECTIVE
To evaluate the antimicrobial susceptibility pattern of oxacillin susceptible (OSSA) and resistant Staphylococcus aureus (ORSA) isolates to other antimicrobial agents that can be used for the treatment of staphylococcal infections.


METHODS
We evaluated 117 clinical S. aureus isolates from several São Paulo hospitals. Clinical isolates from Campinas, SP and from João Pessoa, PB, were also included. The in vitro susceptibility testing was performed by broth microdilution as described by the National Committee for Clinical Laboratory Standards (NCCLS). The minimum inhibitory concentration (MIC) was evaluated for 24 antimicrobial agents, including beta-lactams, fluoroquinolones, aminoglycosides, glycopeptides, macrolides, lincosamides and streptogramins. Both commercially available and experimental drugs were included in the study. Cross-resistance among fluoroquinolones was evaluated by susceptibility testing 24 isolates to 10 fluoroquinolones.


RESULTS
The antimicrobial agents that showed the highest in vitro activity were the glycopeptides, the streptogramin RP-59.500, and the mupirocin (100% susceptibility). Eighty-seven percent of the OSSA and only 38% of the ORSA isolates were susceptible to ciprofloxacin (MIC50 0.25 microgram/mL and > 4 micrograms/mL, respectively). Cross-resistance among fluoroquinolones were noted even for the experimental drugs. Two fluoroquinolones remained active against ciprofloxacin-resistant isolates, clinafloxacin and WIN-57.273. However, the ciprofloxacin-resistant isolates had MICs eight-to 64-fold higher than the ciprofloxacin-susceptible isolates, suggesting that the MICs may continue to increase when these fluoroquinolones become commercially available.


CONCLUSIONS
Our results showed a high rate of antimicrobial resistance among S. aureus from the Brazilian hospitals. Very few drugs can still be used for the treatment of staphylococcal infections.
Farias
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WV
Laboratório Especial de Microbiologia Clínica, Universidade Federal de São Paulo, Escola Paulista de Medicina.
Sader
H S
HS
Leme
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IL
Pignatari
A C
AC
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D006761:Hospitals; D008826:Microbial Sensitivity Tests; D010068:Oxacillin / Q000494:pharmacology / Q000627:therapeutic use; D010406:Penicillins / Q000494:pharmacology / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D010406:Penicillins; D010068:Oxacillin
Padrão de sensibilidade de 117 amostras clínicas de Staphylococcus aureus isoladas em 12 hospitais.