In Vitro Activity of Rifampin, Rifabutin, Rifapentine, and Rifaximin against Planktonic and Biofilm States of Staphylococci Isolated from Periprosthetic Joint Infection

  • Antimicrob Agents Chemother. 2019 Oct 22;63(11):e00959-19. doi: 10.1128/AAC.00959-19.
Mariana Albano  1 Melissa J Karau  1 Kerryl E Greenwood-Quaintance  1 Douglas R Osmon  2  3 Caitlin P Oravec  2 Daniel J Berry  3 Matthew P Abdel  3 Robin Patel  4  2
Affiliations
  • 1. Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
  • 2. Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • 3. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • 4. Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA [email protected].
Abstract

The in vitro activities of rifampin, rifabutin, rifapentine, and rifaximin were tested against 200 periprosthetic joint Infection (PJI)-associated staphylococci. Seven rifampin-resistant isolates had MICs of ≥4 μg/ml. Three isolates had rifampin MICs of 0.25 to 1 μg/ml and harbored an Asp471Gly RpoB variant, suggesting that the CLSI rifampin-susceptible staphylococcal breakpoint of ≤1 μg/ml may be too high. The remaining isolates had rifampin MICs of ≤0.016 μg/ml, and the rifampin, rifabutin, rifapentine, and rifaximin minimum biofilm bactericidal concentrations (MBBC) for ≥50% of isolates were 8, 1, 2, and 4 μg/ml (for S. aureus) and 2, 0.06, 0.25, and 0.5 μg/ml (for S. epidermidis), respectively, for rifampin-susceptible isolates. Nonrifampin rifamycins have promising staphylococcal activity, including antibiofilm activity.

Keywords
Staphylococcus aureus; Staphylococcus epidermidis; biofilm; periprosthetic joint infection; rifabutin; rifampin; rifamycins; rifapentine; rifaximin; rpoB.
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