[Influence of penicillin minimum inhibitory concentration in the synergy between penicillin and gentamicin in viridans-group streptococci].
Penicillin resistance rates higher than 60% have been recorded in viridans group streptococci by some authors during the 90's and recently such resistance was associated with higher levels of mortality in bacteremia. The lowest minimum inhibitory concentration of penicillin for which synergy with aminoglycosides is not yet possible is still unknown. In order to try to dilucidate this puzzle, a study on the susceptibility to penicillin of 28 strains of viridans group streptococci isolated from significant samples in the Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" was carried out. Seven mitis group isolates presenting different susceptibility patterns were selected for performing time-killing curves with penicillin, gentamicin, and penicillin plus gentamicin, using higher and lower penicillin concentrations than their minimal inhibitory concentrations. Synergy was not observed when the penicillin concentration was lower than the minimum inhibitory concentration, at least in these strains with minimum inhibitory concentrations of gentamicin > or = 16 microg/ml. When using penicillin in higher concentrations than the minimum inhibitory concentration, synergy was found in five of the seven strains. Aminoglycoside-modifying enzymes were found in the two other streptococci.
Vigliarolo
L
L
Servicio de Laboratorio, Hospital Zonal Gral. de Agudos San Roque, Gonnet, Argentina.
Ramírez
M S
MS
Centrón
D
D
Lopardo
H
H
D015169:Colony Count, Microbial / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D005839:Gentamicins / Q000008:administration & dosage / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000008:administration & dosage / Q000494:pharmacology*; D012680:Sensitivity and Specificity; D034363:Viridans Streptococci / Q000187:drug effects* / Q000254:growth & development
D005839:Gentamicins; D010406:Penicillins