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Antimicrobial Agents and Chemotherapy, January 2001, p. 243-251, Vol. 45, No. 1
Department of Medical Microbiology and
Infectious Diseases, Erasmus University Medical Center, Rotterdam,
The Netherlands
Received 26 June 2000/Returned for modification 26 August
2000/Accepted 25 October 2000
To determine the efficacy of trovafloxacin as a possible treatment
for intra-abdominal abscesses, we have developed an anaerobic time-kill
technique using different inocula to study the in vitro killing of
Bacteroides fragilis in pure culture or in mixed culture with either Escherichia coli or a vancomycin-resistant
strain of Enterococcus faecium (VREF). With inocula of
5 × 105 CFU/ml and trovafloxacin concentrations of
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.1.243-251.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
In Vitro Activity of Trovafloxacin against Bacteroides
fragilis in Mixed Culture with either Escherichia
coli or a Vancomycin- Resistant Strain of Enterococcus
faecium Determined by an Anaerobic Time-Kill
Technique
2 µg/ml, a maximum observed effect (Emax)
of
6.1 (log10 CFU/ml) was attained with all pure and
mixed cultures within 24 h. With inocula of 108
CFU/ml, a similar Emax and a similar
concentration to produce 50% of Emax
(EC50) for B. fragilis were found in both
pure cultures and mixed cultures with E. coli. However, to
produce a similar killing of B. fragilis in the mixed
cultures with VREF, a 14-fold increase in the concentration of
trovafloxacin was required. A vancomycin-susceptible strain of E. faecium and a trovafloxacin-resistant strain of E. coli were also found to confer a similar "protective" effect
on B. fragilis against the activity of trovafloxacin. Using inocula of 109 CFU/ml, the activity of trovafloxacin was
retained for E. coli and B. fragilis and was
negligible against VREF. We conclude that this is a useful technique to
study the anaerobic killing of mixed cultures in vitro and may be of
value in predicting the killing of mixed infections in vivo. The
importance of using mixed cultures and not pure cultures is clearly
shown by the difference in the killing of B. fragilis in
the mixed cultures tested. Trovafloxacin will probably be ineffective
in the treatment of infections involving large numbers of enterococci.
However, due to its ability to retain activity against large cultures
of B. fragilis and E. coli, trovafloxacin could
be beneficial in the treatment of intra-abdominal abscesses.
*
Corresponding author. Mailing address: Department of
Medical Microbiology and Infectious Diseases, Erasmus University
Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The
Netherlands. Phone: 31-01-4087665. Fax: 31-10-4089454. E-mail:
stearne{at}kmic.fgg.eur.nl.
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