STAPHYLOCOCCUS-EPIDERMIDIS - EMERGING RESISTANCE AND NEED FOR ALTERNATIVE AGENTS

Previously, Staphylococcus epidermidis and other coagulase-negative st aphylococci isolated from the blood of hospitalized patients were ofte n considered contaminants, Now, coagulase-negative staphylococci are a mong the leading causes of nosocomial blood infections. Multidrug resi stance could predict a true nosacomial infection rather than a blood c ulture contaminant. Recent studies indicated the emergence of resistan ce to the quinolones, particularly to ciprofloxacin. Tolerance and occ asional resistance to vancomycin have been reported recently. In addit ion, several reports indicated that vancomycin and other glycopeptide antibiotics lose their effectiveness against S. epidermidis organisms embedded in the biofilm environment on the surface of medical devices. Alternative agents have been proposed in the prevention and treatment of device-related and glycopeptide-tolerant S. epidermidis infections . These agents include minocycline, rifampin, and, more recently, quin upristin/dalfopristin and the oxazolidinones.