Abstract
Propionibacterium acnes has been identified as a significant agent of nosocomial infections, including endophthalmitis. Data concerning susceptibility of P. acnes to newer beta-lactam antibiotics and fluoroquinolones are limited. Recent reports suggest that quinolones have activity against these organisms sufficient to warrant further study. We undertook a study to select appropriate antimicrobial agents for use in a rabbit model of P. acnes endophthalmitis. We compared the antibiotic susceptibilities of P. acnes by using the National Committee for Clinical Laboratory Standards method of agar dilution with the E test. Thirteen clinical isolates obtained from eye specimens and three American Type Culture Collection control strains were tested against 14 antibiotics. All the clinical isolates were susceptible by both methods to piperacillin, piperacillin-tazobactam, ampicillin-sulbactam, ticarcillin-clavulanate, cefotaxime, cefotetan, ceftriaxone, cefoxitin, and imipenem in addition to clindamycin but were resistant to metronidazole. The clinical P. acnes isolates also displayed high-level susceptibility to ciprofloxacin, sparfloxacin, and ofloxacin. Almost all the P. acnes strains demonstrated E-test MICs within 2 dilutions of the MICs observed by the agar dilution method. Those few strains for which discrepancies were noted exhibited E-test susceptibilities three- to fivefold dilutions lower than the agar dilution method susceptibilities but only with ampicillin-sulbactam, ticarcillin-clavulanate, and/or clindamycin. On the basis of our study, all of clinical eye isolates were susceptible to these newer antimicrobial agents and the two methods demonstrated similar susceptibility patterns.
Full Text
The Full Text of this article is available as a PDF (161.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brook I., Frazier E. H. Infections caused by Propionibacterium species. Rev Infect Dis. 1991 Sep-Oct;13(5):819–822. doi: 10.1093/clinids/13.5.819. [DOI] [PubMed] [Google Scholar]
- Citron D. M., Ostovari M. I., Karlsson A., Goldstein E. J. Evaluation of the E test for susceptibility testing of anaerobic bacteria. J Clin Microbiol. 1991 Oct;29(10):2197–2203. doi: 10.1128/jcm.29.10.2197-2203.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fass R. J., Prior R. B. Comparative in vitro activities of piperacillin-tazobactam and ticarcillin-clavulanate. Antimicrob Agents Chemother. 1989 Aug;33(8):1268–1274. doi: 10.1128/aac.33.8.1268. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldstein E. J., Citron D. M. Comparative activity of ciprofloxacin, ofloxacin, sparfloxacin, temafloxacin, CI-960, CI-990, and WIN 57273 against anaerobic bacteria. Antimicrob Agents Chemother. 1992 May;36(5):1158–1162. doi: 10.1128/aac.36.5.1158. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldstein E. J. Patterns of susceptibility to fluoroquinolones among anaerobic bacterial isolates in the United States. Clin Infect Dis. 1993 Jun;16 (Suppl 4):S377–S381. doi: 10.1093/clinids/16.supplement_4.s377. [DOI] [PubMed] [Google Scholar]
- Hecht D. W., Lederer L. Effect of choice of medium on the results of in vitro susceptibility testing of eight antibiotics against the Bacteroides fragilis group. Clin Infect Dis. 1995 Jun;20 (Suppl 2):S346–S349. doi: 10.1093/clinids/20.supplement_2.s346. [DOI] [PubMed] [Google Scholar]
- Ormerod L. D., Edelstein M. A., Schmidt G. J., Juarez R. S., Finegold S. M., Smith R. E. The intraocular environment and experimental anaerobic bacterial endophthalmitis. Arch Ophthalmol. 1987 Nov;105(11):1571–1575. doi: 10.1001/archopht.1987.01060110117044. [DOI] [PubMed] [Google Scholar]
- Whitcup S. M., Belfort R., Jr, de Smet M. D., Palestine A. G., Nussenblatt R. B., Chan C. C. Immunohistochemistry of the inflammatory response in Propionibacterium acnes endophthalmitis. Arch Ophthalmol. 1991 Jul;109(7):978–979. doi: 10.1001/archopht.1991.01080070090041. [DOI] [PubMed] [Google Scholar]
- Zambrano W., Flynn H. W., Jr, Pflugfelder S. C., Roussel T. J., Culbertson W. W., Holland S., Miller D. Management options for Propionibacterium acnes endophthalmitis. Ophthalmology. 1989 Jul;96(7):1100–1105. doi: 10.1016/s0161-6420(89)32768-0. [DOI] [PubMed] [Google Scholar]