Clinical Microbiology and Antimicrobial Chemotherapy. 2013; 15(2):115-123
To determine the most effective antibiotics for therapy of infectious complications of prosthetic joint implantation caused by S. aureus and S. epidermidis.
The antibiotic resistance profiles were determined for 535 clinical S. aureus and 211 S. epidermidis isolates. All the strains were isolated from the removed prosthesis and biological samples from patients with prosthetic joint infection (PJI). Susceptibility of clinical isolates was determined to 14 antibiotics according to EUCAST guidelines. Statistical analysis was performed using Z-criterion.
23,9% of S. aureus and 56,6% of S. epidermidis strains were methicillin-resistant (MR). It was not revealed any strain to be resistant to vancomycin, teicoplanin and linezolid. The only one strain was resistant to fusidic acid. About 90% of all strains tested were susceptible to fosfomycin and up to 80% of MRSA isolates were susceptible to co-trimoxazole. Rifampicin was active against 74–75% of MR staphylococci. MRSA was found to be 14,3% and 24,7% more resistant than MRSE to clindamycin and moxifloxacin (p<0,05); but less resistant to erythromycin, tetracycline and co-trimoxazole to 12,9–35,3% (p<0,05).
The majority of staphylococci causing PJI were resistant to methicillin and other antibiotics. This fact together with pathogenesis of PJI is serious clinical problem. Combined antibacterial therapy may be more effective against staphylococci including intracellular and biofilm associated forms. Combination of vancomycin or linezolid with fosfomycin, rifampicin, co-trimoxazole or gentamicin seems to be more perspective.