In vitro activity of tedizolid and linezolid against Staphylococcus epidermidis isolated from prosthetic joint infections.
Prosthetic joint infections (PJIs) are rare but long-lasting and are serious complications without any spontaneous resolution, requiring additional surgery and long-term treatment with antibiotics. Staphylococci are the most important aetiological agents of PJIs, and among the coagulase-negative staphylococci Staphylococcus epidermidis is the most common. However, S. epidermidis often displays multidrug resistance (MDR), demanding additional treatment options. The objective was to examine the effectiveness of tedizolid and linezolid against S. epidermidis isolated from PJIs. The standard antibiotic susceptibility pattern of S. epidermidis (n = 183) obtained from PJIs was determined by disc diffusion test, and MIC was determined by Etest for tedizolid, linezolid, and vancomycin. Tedizolid displayed MIC values ranging from 0.094 to 0.5 mg/L (MIC50: 0.19 mg/L, MIC90: 0.38 mg/L), linezolid MIC values ranging from 0.25 to 2 mg/L (MIC50: 0.75 mg/L, MIC90: 1 mg/L), and vancomycin MIC values ranging from 0.5 to 3 mg/L (MIC50and MIC90both 2 mg/L). According to the disc diffusion test, 153/183 (84%) isolates were resistant to ≥3 antibiotic groups, indicating MDR. In conclusion, S. epidermidis isolates from PJIs were fully susceptible, and the MIC50and MIC90values for tedizolid were two- to four-fold dilution steps lower compared with linezolid. Tedizolid is not approved, and there are no reports of long-term treatment, but it may display better tolerability and fewer adverse effects than linezolid; it thus could be a possible treatment option for PJIs, alone or in combination with rifampicin.
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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Littorin
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.|Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
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Hellmark
Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.|Department of Infectious Diseases, County Council of Östergötland, Linköping, Sweden.
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Nilsdotter-Augustinsson
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. bo.soderquist@oru.se.|Departments of Infectious Diseases and Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, SE-701 85, Örebro, Sweden. bo.soderquist@oru.se.
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Söderquist
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001170:Arthritis, Infectious / Q000382:microbiology*; D006801:Humans; D000069349:Linezolid / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D010755:Organophosphates / Q000494:pharmacology*; D010080:Oxazoles / Q000494:pharmacology*; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D010755:Organophosphates; D010080:Oxazoles; D000069349:Linezolid; C515040:tedizolid phosphate
Cefoxitin; Linezolid; Norfloxacin; Rifampicin; Vancomycin