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Double-disk synergy test positivity inStenotrophomonas maltophilia clinical strains

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Abstract

The double-disk synergy test (DDST) using Mueller-Hinton agar and antibiotic disks with centrally positioned disks of amoxicillin-clavulanate, ampicillin-sulbactam, and piperacillin-tazobactam and, at a center-to-center distance of 25–30 mm, 2–4 disks with 10 various β-lactam antibiotics per one plate was performed in 58 clinical isolates ofStenotrophomonas maltophilia to determine the effectivity of 3 β-lactamase inhibitors. When tested with clavulanate as the central β-lactamase inhibitor synergic action on tested strains was the most frequent with aztreonam (81.0 % of strains), cefoperazone (63.8 %), and cefepime (60.3 %). With sulbactam the synergic action,i.e. DDST positivity, was high in the case of cefoperazone (15.5 %), ampicillin, aztreonam and piperacillin (8.6 % each); with tazobactam it was the most frequent with aztreonam (53.4 %), cefoperazone (44.8 %) and cefepime (37.9 %). No synergy was demonstrated after application of meropenem regardless of the kind of β-lactamase inhibitor used. In 58 strains ofS. maltophilia, 55 different profiles of DDST positivity were found. The results confirm that clavulanate is the most effective inhibitor ofS. maltophilia β-lactamases. The utilization of DDST (performed in the recommended way) for the typization of strainsStenotrophomonas species and for the estimation of potential effectiveness combinations of β-lactams with β-lactamase inhibitors for the therapy of stenotrophomonade infections was suggested.

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Abbreviations

DDST:

double-disk synergy test

ESBL:

extended-spectrum β-lactamases

β-lac:

β-lactamase

Amp:

ampicillin

Amx:

amoxicillin

Azt:

aztreonam

Cef:

cefepime

Cfa:

ceftazidime

Cfm:

cefpirome

Cfp:

cefoperazone

Cft:

ceftriaxone

Cfx:

cefotaxime

Cla:

clavulanate

Mer:

meropenem

Pip:

piperacillin

Sul:

sulbactam

Taz:

tazobactam

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Authors and Affiliations

  1. Institute of Microbiology, Faculty of Medicine, Palacky University, 775 15, Olomouc, Czechia

    P. Hejnar & M. Kolár

  2. Institute of Pathological Physiology, Faculty of Medicine, Palacky University, 775 15, Olomonac, Czechia

    Z. Chmela

Authors
  1. P. Hejnar
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  2. M. Kolár
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  3. Z. Chmela
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Correspondence to P. Hejnar.

Additional information

This work was supported by research project of theMinistry of Education, Youth and Sports of the Czech Republic no. MSM 151100002.

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Hejnar, P., Kolár, M. & Chmela, Z. Double-disk synergy test positivity inStenotrophomonas maltophilia clinical strains. Folia Microbiol 49, 71–74 (2004). https://doi.org/10.1007/BF02931649

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