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4 protocols using teicoplanin

1

Antibiotic Susceptibility Profiling

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Susceptibility to 13 antibiotics was determined by the disc diffusion method and using the ADAGIO™ Automated System (Bio-Rad, Hercules, CA, USA) as described. The antibiotics tested included ampicillin (10 µg), penicillin (6 µg), ampicillin/sulbactam (20 µg), chloramphenicol (30 µg), vancomycin (5 µg), teicoplanin (30 µg), streptomycin (300 µg), gentamicin (120 µg), ciprofloxacin (5 µg), levofloxacin (5 µg), quinupristin-dalfopristin (15 µg), linezolid (30 µg) and tigecycline (15 µg) (Bio-Rad, Hercules, CA, USA)]. Susceptibility to aminoglycosides, glycopeptides, quinolones and β-lactam antibiotics was also determined by an E-test (M.I.C. Evaluator™, OXOID, Basingstoke, UK). The methods and the interpretation of the results followed the CLSI guidelines [32 ]. Enterococcus faecalis ATCC 29212 and Staphylococcus aureus ATCC 25923 were used as control strains.
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Antibiotic Susceptibility of Enterococci

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A bacterial suspension of density equivalent to a MacFarland of 0.5 was used to inoculate an MH agar plate using a sterile swab. An Etest® (Biomérieux, Marcy-l’Etoile, France) containing ciprofloxacin was loaded onto the agar and incubated overnight at 37 °C before MIC determination. In parallel, an antibiogram of Enterococci was performed by disk diffusion method using the following molecules (Bio-Rad, Hercules, CA, USA): ampicillin (2 µg), imipenem (10 µg), norfloxacin (10 µg), rifampicin (5 µg), erythromycin (10 µg), clindamycin (2 µg), quinuspristin-dalfopristin (15 µg), tigecycline (15 µg), linezolid (10 µg), levofloxacin (5 µg), gentamicin (30 µg), streptomycin (300 µg), vancomycin (5 µg), teicoplanin (30 µg), nitrofurantoin (100 µg), fosfomycin (200 µg). The interpretations were carried out according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines (https://www.eucast.org/clinical_breakpoints, 2022).
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Antibiotic Susceptibility Testing Protocol

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Antibiotic susceptibility was measured with the use of the standard disc diffusion process suggested by the Clinical and Laboratory Standards Institute (CLSI) guidelines by broth microdilution and E-test (cat. nos. 537300, 501800, 533500, 501300, 501600, 506710, 513800, 526000, 523600, 525508, 522000, 503500 and 521400; AB Biodisk; BioMérieux Inc.) (17 ). A total of 14 antibiotics were tested, including ampicillin-sulbactam, trimethoprim-sulfamethoxazole, aminoglycoside antibiotic amikacin, macrolide antibiotic azithromycin, β-lactam antibiotic aztreonam, β-lactamase inhibitor tazobactam, cephalosporin antibiotics ceftazidime and cephalothin, rifampin and tigecycline, carbapenem antibiotic meropenem and colistin, and the glycopeptide antibiotics teicoplanin and vancomycin (Bio-Rad, Laboratories, Inc., Hercules, CA, USA). These antibiotics are of different classes and have different killing mechanisms on the bacteria. The E-test technique was used to determine the minimum inhibitory concentrations (MICs) of meropenem. The results were interpreted according to the CLSI guidelines from 2015 (18 ).
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Antibiotic Resistance Profiling of Enterococci

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The antibiotic resistance of enterococci isolates was determined by the disc diffusion method recommended by the Clinical and Laboratory Standards Institute (CLSI, 2012 ). The following antimicrobial drugs (Bio-Rad, Marnes-la-Coquette, France) were used: vancomycin (30 μg), teicoplanin (30 μg), ampicillin, (10 μg), erythromycin (15 μg), tetracycline (30 μg), minocycline (30 μg), quinupristin–dalfopristin (15 μg), ciprofloxacin (5 μg), chloramphenicol (30 μg), nitrofurantoin (300 μg), and linezolid (30 μg), and for high-level resistance (HLR) gentamicin (120 μg) and streptomycin (300 μg).
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