Antimicrobial Susceptibilities of Geographically Diverse Clinical Human Isolates of Leptospira

Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
Antimicrobial Agents and Chemotherapy (Impact Factor: 4.48). 05/2008; 52(8):2750-4. DOI: 10.1128/AAC.00044-08
Source: PubMed


Although antimicrobial therapy of leptospirosis has been studied in a few randomized controlled clinical studies, those studies
were limited to specific regions of the world and few have characterized infecting strains. A broth microdilution technique
for the assessment of antibiotic susceptibility has been developed at Brooke Army Medical Center. In the present study, we
assessed the susceptibilities of 13 Leptospira isolates (including recent clinical isolates) from Egypt, Thailand, Nicaragua, and Hawaii to 13 antimicrobial agents. Ampicillin,
cefepime, azithromycin, and clarithromycin were found to have MICs below the lower limit of detection (0.016 μg/ml). Cefotaxime,
ceftriaxone, imipenem-cilastatin, penicillin G, moxifloxacin, ciprofloxacin, and levofloxacin had MIC90s between 0.030 and 0.125 μg/ml. Doxycycline and tetracycline had the highest MIC90s: 2 and 4 μg/ml, respectively. Doxycycline and tetracycline were noted to have slightly higher MICs against isolates from
Egypt than against strains from Thailand or Hawaii; otherwise, the susceptibility patterns were similar. There appears to
be possible variability in susceptibility to some antimicrobial agents among strains, suggesting that more extensive testing
to look for geographic variability should be pursued.

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