Population analysis of susceptibility to ciprofloxacin and nalidixic acid in Staphylococcus, Pseudomonas aeruginosa, and Enterobacteriaceae.

Susceptibility to ciprofloxacin (Cfl) and nalidixic acid (Nal) was tested in vitro by means of the population analysis technique against six strains of Staphylococcus, one strain of Pseudomonas aeruginosa, and seven strains from five genera of Enterobacteriaceae. All strains of Staphylococcus were uniformly resistant to Nal as was the Pseudomonas aeruginosa strain, all bacteria being resistant to 250- less than 500 micrograms/ml. The Enterobacteriaceae were heterogeneous as regards susceptibility to Nal. With some strains minority populations of highly-resistant bacteria could be detected with frequencies of about 10(-6.3). The MIC for Cfl for the staphylococci varied between 0.25 and 0.50 microgram/ml. There were no differences in MIC of penicillinase-producing and penicillin-susceptible strains, either in Staphylococcus aureus or in Staphylococcus epidermidis. The MIC for Cfl in the enterobacteria varied between 0.004 and 0.03 microgram/ml. The MIC for Cfl in the Pseudomonas aeruginosa was 0.25 microgram/ml. MIC for Cfl increased in all strains when the parental strains were compared to bacteria selected from the plates with the highest concentration permitting growth, indicating heterogeneity against Cfl. But while the MIC of the selected enterobacteria were lower than one fourth of the level obtainable in serum, the MIC of the selected staphylococci and Pseudomonas aeruginosa were either exceeding the level obtainable in serum or were only a little lower than this level. While Cfl thus seems to be a promising antimicrobial agent in the treatment of infections caused by enterobacteria, the suitability for infections caused by staphylococci and Pseudomonas aeruginosa should be further explored.