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PubMed2006

Does vaginal douching affect the risk of vaginal infections in pregnant women?

OBJECTIVE: To evaluate the relationship between vaginal douching and vaginal infections among women in early pregnancy. METHODS: We conducted this study in the Department of Gynecology and Obstetrics, Family Planning Center, Dr. E. Hayri Ustundag Hospital, Izmir, Turkey, between March 2003 and December 2004. We examined the vaginal swabs of 129 women, asking for termination of pregnancy in a family-planning center as both wet-preparations and cultures for vaginal microorganisms, and recorded the informations on women's vaginal douching habit. RESULTS: Among 129 women examined, 80 had at least one type of vaginal microorganisms. Of 67 vaginal douche users, 48 (71.6%) had at least one type of vaginal organisms, whereas of 62 nonusers, only 32 (51.6%) had microorganism, although age, educational status, coital frequency, age at the first intercourse were not statistically different between the vaginal douche-users and non-users. Especially, Group B Streptococcus (GBS), Enterococcus spp. and Candida spp. were found more frequent in vaginal douche-user women. CONCLUSION: We found that vaginal douching tends pregnant women to genital tract the incidence of vaginal infections, especially those caused by Enterococcus spp. and GBS. As such infections may render such women to high risk in terms of perinatal mortality and morbidity, it would be appropriate to discourage vaginal douching in pregnant women.

Adolescent↗

PubMed2000

Antimicrobial resistance among urinary tract infection (UTI) isolates in Europe: results from the SENTRY Antimicrobial Surveillance Program 1997.

The SENTRY Antimicrobial Surveillance Program was established to monitor the occurrence and antimicrobial susceptibility of bacterial pathogens via an international network of sentinel hospitals. Twenty European hospitals referred a total of 887 urinary tract infection (UTI) isolates to the European SENTRY reference laboratory during the period October-December 1997. Ninety percent of the referred species were represented by Escherichia coli (52%), Enterococcus spp. (12%), Klebsiella spp. (7%), Proteus spp. (7%), Pseudomonas aeruginosa (7%), and Enterobacter spp. (5%). The susceptibility of E. coli isolates to penicillins was less than 60%, while almost all of the isolates were susceptible to piperacillin/tazobactam (98% susceptibility), cephalosporins (98%), and carbapenems (100%). Amikacin was the best aminoglycoside (99.8% susceptibility). The susceptibility to quinolones was only 88-89%, with highest levels of resistance observed for isolates from Portugal, Italy, England, The Netherlands, and some centers in France, Spain, and Poland. The susceptibility of Klebsiella spp. to the newer generations of cephalosporins was 82-95% and to the carbapenems 100%. Amikacin was again the best aminoglycoside (94% susceptibility). The susceptibility of Enterobacter spp. to any beta-lactam antibiotic was poor, except for the carbapenems (100% susceptibility) and cefepime (90% susceptibility), while the susceptibility to aminoglycosides was 80-89%. Proteus spp. showed complete susceptibility to cefepime, ceftriaxone, the carbapenems, and piperacillin/tazobactam, while the susceptibility of P. aeruginosa isolates was poor, with best results for the carbapenems (susceptibility 89%), piperacillin/tazobactam (susceptibility 84%), and amikacin and ticarcillin (susceptibility to both 80%). Enterococcus spp. showed the highest susceptibility to vancomycin (98%), teicoplanin (98%), and ampicillin (94%).

Candida↗

PubMed1999

Survey of blood stream infections attributable to gram-positive cocci: frequency of occurrence and antimicrobial susceptibility of isolates collected in 1997 in the United States, Canada, and Latin America from the SENTRY Antimicrobial Surveillance Program. SENTRY Participants Group.

The SENTRY Antimicrobial Surveillance Program was established in January, 1997 to monitor the predominant pathogens and antimicrobial resistance patterns of nosocomial and community-acquired infections via a network of sentinel hospitals in the United States (30 sites), Canada (eight sites), Latin America (10 sites), and Europe (24 sites). During the first 12-month study period (January to December, 1997), a total of 9519 blood stream infections (BSI) were reported by SENTRY participants in the U.S. (6150), Canada (1727), and Latin America (1642). The Gram-positive cocci, Staphylococcus aureus, coagulase-negative staphylococci (CoNS), enterococci, and streptococci accounted for 53.9% (5131 infections) of all BSI (56.5% U.S., 55.7% Canada, and 42.9% Latin America). The staphylococci, Enterococcus spp., S. pneumoniae, beta-hemolytic streptococci, and viridans group streptococci accounted for 6 of the top 11 BSI pathogens in the U.S. and Canada, whereas only S. aureus (1st), CoNS (3rd), and Enterococcus spp. (9th) were among the top 11 pathogens in Latin American hospitals. The results of this survey affirm the importance of Gram-positive cocci as causes of BSI in both North America and Latin America and demonstrate that important antimicrobial resistance exists among isolates of staphylococci, streptococci, and enterococci from all three geographic regions. This includes oxacillin-resistance among S. aureus (26.9% U.S., 29.2% Latin America, and 4.0% Canada) and CoNS (71.5% U.S., 68.4% Latin America, and 65.6% Canada), penicillin resistance among viridans group streptococci (48.5% U.S., 45.1% Canada, and 33.3% Latin America) and pneumococci (36.1% U.S., 27.5% Canada, and 65.6% Latin America), high-level resistance (HLR) to aminoglycosides among enterococci (27.2 to 70.1% U.S., 33.3 to 75.7% Canada and 16.7 to 51.5% Latin America), and macrolide resistance among beta-hemolytic streptococci (12.4 to 14.2% U.S., 10.5 to 12.3% Canada, and 0.0 to 4.0% Latin America), viridans group streptococci (32.4 to 39.7% U.S., 22.5-35.2% Canada, and 20.0% Latin America), and pneumococci (10.0 to 10.6% U.S., 9.8-10.8% Canada, and 9.4-18.7% Latin America). BSI isolates of Gram-positive cocci from the U.S. and Latin America were considerably more resistant than those from Canada. New agents with Gram-positive activity will be essential for optimal treatment of BSI attributable to Gram-positive cocci in both North and Latin America.

Anti-Bacterial Agents↗

PubMedDate not supplied

Analysis of the bacterial strains isolated from urine samples of hospitalized and ambulatory patients.

Bacteria of Enterococcus spp. are now much more often isolated from various diagnostic materials in systemic infection, both in hospitalized and in ambulatory patients. The study included 571 enterococci strains isolated from urine in 1997. Species identification was performed by rapid ID32 STREP test (bioMérieux) for 327 analyzed strains. Enterococcus faecalis and Enterococcus faecium dominated (46.1% and 11.2%, respectively). Over 42% of strains were isolated from urine of patients with non-significant bacteriuria or as concomitant flora. In such cases, simplified identification was performed and the strains were determined as Enterococcus spp. The microorganisms analyzed originated primarily from the urine samples of patients hospitalized at the Department of Urology (41.8%), the Department of Neurology (11.9%) and the Department of Internal Medicine and Nephrology (9.9%). Enterococcus faecalis strains were second with respect to population count (263--10.6%), after Escherichia coli strains (464--18.8%), while Enterococcus faecium strains were the sixth (64--2.5%). Enterococcus genus took the first place among all microorganisms isolated from the urine samples. Antibiotic-sensitivity was determined for 323 enterococci strains originating from hospitalized and ambulatory patients. Enterococcus faecium strains, naturally resistant to beta-lactam antibiotics, were sensitive to nitrofuranoin in more than 50% and to norfloxacin in about 20%. Among 254 analyzed Enterococcus faecalis strains, 80.0% were sensitive to ampicillin, nitrofurantoin and high concentrations of gentamicin as well as streptomycin. Enterococci strains isolated from hospitalized patients proved sensitive to ampicillin and carbapenems in 76.8%, while strains isolated from ambulatory patients were 100% sensitive to these drugs. Examination of enterococci isolated from urine of patients hospitalized showed 33.8% sensitive to norfloxacin and 84.6% sensitive to nitrofurantoin. All the enterococci strains were sensitive to glycopeptide antibiotics: vancomycin, teicoplanin.

Bacteriuria↗

PubMed2006

[Resistance to antimicrobial drugs in Enterococcus sp. strains isolated in hospitals of Northern Chile].

The prevalence of different species of Enterococcus and the resistance to antimicrobial drugs was studied in strains isolated in 5 hospitals of Northern Chile. A total of 249 of Enterococcus spp strains were included in this study. Enterococci were mostly isolated from urine and wounds. Among five species identified, E. faecalis and E. faecium were most frequently isolated in the all hospitals. High susceptibility to beta-lactam antibiotics, moderate resistance to tetracycline, ciprofloxacin and erythromycin, and high resistance to chloramphenicol was observed. Vancomycin resistance was absent. Approximately 12% of Enterococcus spp strains presented high level of gentamicin resistance. Multiresistance to 3 or more antimicrobial agents was detected in 30% of total Enterococcus strains studied.

Anti-Bacterial Agents↗

PubMed1999

In vitro activities of macrolides against gram-positive aerobes, Haemophilus influenzae, Moraxella catarrhalis and Bacteroides fragilis in Taiwan.

BACKGROUND: New macrolides with improved pharmacokinetic characteristics have been developed and introduced for clinical use in Taiwan. In order to understand the antibacterial activities of these new macrolides, we tested their in vitro activities against common pathogenic bacteria. METHODS: Minimum inhibitory concentrations (MICs) of azithromycin, clarithromycin, dirithromycin, erythromycin and roxithromycin for clinical isolates collected from six teaching hospitals in Taiwan were determined by the agar dilution method. The tested bacteria included methicillin-sensitive and -resistant coagulase-negative staphylococci, methicillin-sensitive and -resistant Staphylococcus aureus, viridans streptococci, Streptococcus pneumoniae, Streptococcus pyogenes, Enterococcus spp, Corynebacterium spp, Haemophilus influenzae, Moraxella catarrhalis and Bacteroides fragilis. RESULTS: High MICs were detected against most of the bacteria tested except for H influenzae and M catarrhalis. The MIC90 for viridans streptococci, S pneumoniae, S pyogenes, Enterococcus spp, S aureus (both methicillin-sensitive and -resistant), coagulase-negative staphylococci (both methicillin-sensitive and -resistant), Coryne-bacterium spp, and B fragilis were all at least 128 micrograms/ml. Wide ranges of MICs were demonstrated. CONCLUSIONS: Most bacteria tested were highly resistant to macrolides. This result is a warning for clinicians that rational use of antibiotics, including macrolides, is mandatory.

Anti-Bacterial Agents↗

PubMed1999

Susceptibility to levofloxacin of clinical isolates of bacteria from intensive care and haematology/oncology patients in Switzerland: a multicentre study.

The objective of this study was to examine the susceptibility of clinical isolates to levofloxacin, a fluoroquinolone with extended activity against Gram-positive bacteria, and other antibiotics in 12 Swiss clinical microbiology laboratories using the NCCLS disc diffusion technique. Isolates were prospectively collected from intensive care units (ICUs (59%), oncology wards (7%) and other units with haematology/oncology patients (34%) from June 1995 to March 1996. The levofloxacin breakpoints used were as recommended by the manufacturer. A total of 310 Gram-positive and 580 Gram-negative isolates from the respiratory tract (36%), skin/wounds (12%), blood (16%), urine (17%) and other sources (19%) were tested. The percentage of isolates susceptible to levofloxacin was 100% for Enterococcus spp. (38 strains), Streptococcus agalactiae (13), Streptococcus pneumoniae (65), Acinetobacter spp. (11), Citrobacter diversus (6), Citrobacter freundii (17), Klebsiella oxytoca (39), Morganella morganii (16), Proteus mirabilis (20), Proteus vulgaris (23), Serratia spp. (19), Stenotrophomonas maltophilia (10) and Haemophilus influenzae (41). The percentage of isolates susceptible to levofloxacin for Staphylococcus aureus (95 strains, including 2% MRSA) was 94%, coagulase-negative staphylococci (85) 65%, Enterobacter spp. (75) 99%, Escherichia coli (111) 97%, Klebsiella pneumoniae (45) 98% and Pseudomonas aeruginosa (124) 87%. In conclusion, levofloxacin is a new fluoroquinolone to which the most common clinical isolates in Switzerland are susceptible. The susceptibility of Enterococcus spp. and S. pneumoniae to levofloxacin was particularly remarkable. This compound appears to be a promising therapeutic alternative for the treatment of Gram-positive infections.

Anti-Infective Agents↗

PubMed2006

Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: report from the SENTRY Antimicrobial Surveillance Program (1998-2004).

The morbidity and cost for cure associated with skin and soft tissue infections (SSTIs) have recently become more complicated because of the increasing prevalence of multidrug-resistant pathogens associated with this healthcare problem. The SENTRY Antimicrobial Surveillance Program has been monitoring SSTI since 1997, and now presents data from 3 continents over a 7-year period (1998-2004). Isolates were tested by reference broth microdilution methods at a central laboratory using the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards) methods and interpretative criteria. The predominant pathogens included Staphylococcus aureus (ranked 1st in all geographic regions), Pseudomonas aeruginosa, Escherichia coli, and Enterococcus spp. A considerable variation in the methicillin (oxacillin)-resistant S. aureus rate was noted between countries and continents, with the overall rate highest in North America (35.9%) compared with Latin America (29.4%) and Europe (22.8%). Vancomycin-resistant Enterococcus spp. increased in Europe (4.1%) and North America (6.2%) during the period, but remained low and relatively unchanged in Latin America. Among the P. aeruginosa isolates tested, susceptibility to imipenem was much lower in Latin America (65.3%) compared with the other regions (80.7-88.7%), and resistance being associated with an increase in metallo-beta-lactamase-producing strains in Latin America and in some European countries. Multidrug-resistant strains of P. aeruginosa were also more of a concern in Latin America (24.7%) compared with Europe (10.8%) or North America (3.2%). Latin America also had the highest occurrence of extended-spectrum beta-lactamase-producing isolates among E. coli (15.1%) and Klebsiella spp. (48.0%) when compared with other regions. Continued surveillance of pathogen prevalence and antimicrobial resistance patterns should provide information that is important to improve empiric care particularly in the hospital environment.

Anti-Bacterial Agents↗

PubMed1992

[Evaluation of usefulness of the PYR-Wellcome test for identifying microorganisms from the genus enterococcus].

The study was aimed at evaluation of usefulness of PYR-Wellcome test in bacteriological diagnostic. Results of identification of enterococcal strains by application of the above test were performed on 157 strains of Enterococcus spp., 15 strains of Streptococcus pyogenes and 12 of Streptococcus bovis. Application of test for PYR-ase production results in shortening of diagnostic procedure. Basing on morphological features, including type of hemolysis, lack of catalase production and presence in the bacterial cell of a peptidase hydrolyzing L-pirrolidonyl-beta-naphthylamide, it is possible to classify with high probability the investigated microorganism to the Enterococcus spp. The Shortened procedure is satisfactory for routine identification of enterococcal strains in diagnostic laboratories.

Enterococcus↗

PubMed2006

Lethal outcome in xanthogranulomatous endometritis.

Xanthogranulomatous inflammation is rare, mainly involving the kidneys, while primary xanthogranulomatous endometritis (XE) is a very unusual finding, histologically characterized by partial or complete replacement of the mucosa by granulation tissue with an abundance of foamy histiocytes, siderophages and multinucleated giant cells. We present the case of a 69-year-old woman with a short history of abdominal pain and a palpable mass in the pouch of Douglas. Dilatation of the cervix drained a pyometra. Histological examination of the curettage rendered the diagnosis of XE. Microbiological studies revealed enterococcus spp. and Peptostreptococcus magnus. Despite antibiotic treatment the patient died of heart failure due to systemic inflammation. Autopsy confirmed the diagnosis of XE with transmural extension into the peritoneal cavity. Such a lethal course of XE is extraordinary. Proposed causes of XE include obstruction, infection and hemorrhage. Demonstration of enterococcus spp. and P. magnus supports the probable significance of bacteria in the development of XE. Because this condition may mimic malignant disease macroscopically and histologically, knowledge of XE is of major importance for both pathologists and gynecologists.

Aged↗

PubMed1997

[Optimal antibacterial chemotherapy for infectious diseases associated with hematological malignancies].

The status quo of infectious diseases associated with hematological malignancies was examined for clinical consideration. In addition, in vitro antibacterial activities and combination effects were also examined by means of various isolated strains derived from sepsis. In clinical practice, 76% of the fevers in patients with hematological malignancies was attributed to infectious diseases mainly involving "fever with granulocytopenia", sepsis, and pneumonia. The detection rate of causal pathogen remained at a low level and more than half of the causes of death were infectious diseases. In the in vitro examination, a favorable antibacterial effect was noted with vancomycin (VCM) for methicillin resistant Staphylococcus aureus (MRSA) and Enterococcus spp., imipenem (IPM) for methicillin sensitive S. aureus (MSSA), and ciprofloxacin, amikacin (AMK), and IPM for Pseudomonas aeruginosa and intestinal flora. But its clinical effect is not enough. Synergic and/or additive effect can be expected by combining IPM with VCM for MRSA and Enterococcus spp., and IPM with AMK for P. aeruginosa. These combination therapies were considered to be optimal as antibacterial chemotherapy for infectious diseases associated with hematological malignancies.

Adult↗

PubMed1994

[Bacteria isolated from intraabdominal infection and their susceptibilities to antimicrobial agents].

Bacteria isolated from intraabdominal infections during the period from July 1982 to June 1993 were investigated with regard to their classifications according to a joint research by 9 university hospitals in Japan. The following results were obtained. 1. A total of 971 strains were isolated from 684 out of 597 patients with peritonitis, and 287 strains out of 971 were isolated from postoperative peritonitis. 2. The most predominant organism isolated from patients with acute peritonitis was Escherichia coli (28%), followed by Bacteroides fragilis group (17%), Gram-positive anaerobic cocci (16%), Enterococcus spp. (9%) and Klebsiella spp. (8%). 3. Against E. coli, cefmenoxime, cefuzonam, cefozopran, aztreonam and carumonam showed MIC50 less than 0.05 micrograms/ml. Against B. fragilis group, erthromycin, clindamycin, imipenem, lincomycin and latamoxef showed MIC50 less than 0.78 micrograms/ml. 4. The most predominant organism isolated from patients with postoperative peritonitis was Enterococcus spp. (20%) and followed by Pseudomonas spp. (14%), and Staphylococcus spp. (13%), E. coli (9%), Enterobacter spp. (8%) and Klebsiella spp. (8%). We suggest that cefazolin, cefmetazole, flomoxef, cefmenoxime, cefuzonam, and latamoxef are the first choice agents in empiric therapy for the treatment of acute peritonitis.

Aged↗

PubMedDate not supplied

Antimicrobial resistance from enterococci in a pediatric hospital. Plasmids in Enterococcus faecalis isolates with high-level gentamicin and streptomycin resistance.

BACKGROUND: Enterococcus spp. is an important nosocomial and community-acquired pathogen. Recent studies have documented the increasing importance of this pathogen in children, particularly in the hospital setting. Our objective in this study was to report the frequency of antimicrobial resistance in enterococci and to determine the characteristics of high-level gentamicin resistance (HLGR) plasmids in Enterococcus faecalis clinical isolates. METHODS: Two hundred eighty-nine enterococcal isolates were collected during an 18-month period from a tertiary-care pediatric hospital in Mexico City. Isolates were screened for antibiotic resistance, including HLGR. High-level, gentamicin-resistant E. faecalis strains were selected for pulsed-field electrophoresis (PFGE) typing and plasmid analysis. Transferability of resistance markers was carried out using filter matings. RESULTS: Seventy-six percent of isolates were E. faecalis, 10% were E. avium, 5.2% E. faecium, 5.2% E. raffinossus, 1.38% E. malodoratus, 0.6% E. hirae, and 0.6% E. casseliflavus. Antimicrobial resistance was ampicillin and penicillin 29%, imipenem 17%, and vancomycin 3%, HLGR 5%. The following 15 high-level, gentamicin-resistant isolates were identified: six E. faecalis; four E. avium; three E. faecium, and two E. casseliflavus. Five of the six E. faecalis isolates were different by PFGE and transferred gentamicin and streptomycin resistance on filter membranes. Transfer frequencies ranged from 8.2 x 10(-4) to 6.92 x 10(-5) transconjugants/recipient cell. The plasmid content of donors and transconjugants were homogeneous (one plasmid of 47 kb). CONCLUSIONS: In this pediatric hospital, antimicrobial resistance in Enterococcus spp. is common. Frequency of high-level, gentamicin-resistant strains is low. Mechanism of HLGR appears to be due to a single plasmid dissemination.

Drug Resistance, Microbial↗

PubMed2005

Enumeration and antibiotic resistance patterns of fecal indicator organisms isolated from migratory Canada geese (Branta canadensis).

Thermotolerant fecal indicator organisms carried by migratory waterfowl may serve as reservoirs of antibiotic resistance. To determine the extent to which such antibiotic resistance markers were present in migratory Canada geese (Branta canadensis) on the Maryland Eastern Shore, we isolated Enterococcus spp. and Escherichia coli from fresh feces and examined the antibiotic resistance profiles of these bacteria. Samples were obtained in October 2002, January 2003, and March 2003. Thermotolerant E. coli counts ranged from 0 to 1.0x10(7) colony forming units (CFU)/0.1g (g-1) wet weight of feces, whereas Enterococcus spp. counts ranged from 1.0x10(2)-1.0x10(7) CFU g-1 wet weight of feces. Primary isolates of each indicator organism were tested against a panel of 10 antibiotics. Greater than 95% of E. coli isolates were resistant to penicillin G, ampicillin, cephalothin, and sulfathiazole; no E. coli were resistant to ciprofloxacin. Enterococcal isolates showed highest resistance to cephalothin, streptomycin, and sulfathiazole; no enterococci were resistant to chloramphenicol. The tetracyclines, streptomycin, and gentamycin provided the greatest discrimination among E. coli isolates; chlortetracycline, cephalothin, and gentamycin resistance patterns provided the greatest discrimination between enterococcal strains. Multiple antibiotic resistance (MAR) profiles were calculated: fall (E. coli=0.499; enterococci=0.234), winter (E. coli=0.487; enterococci=0.389), and spring (E. coli=0.489; enterococci=0.348). E. faecalis and E. faecium, which are recognized human nosocomial pathogens, were cultured from winter (44 and 56%, respectively) and spring (13 and 31%, respectively) fecal samples.

Animal Migration↗

PubMed2001

Implications of multiple antimicrobial-resistant enterococci associated with the poultry environment.

Poultry are increasingly being associated with carriage of multiresistant organisms that may cause disease in humans. Among these organisms are the enterococci, not regarded as a common cause of hospital-acquired infections. The use of antimicrobials for growth promotion in poultry production envronments may facilitate the dissemination of resistance to Enterococcus spp. that have the potential to be clinically significant. To assess descriptively the degree of multiresistant enterococci in the poultry environment of the Delmarva (Delaware-Maryland-Virginia) East Coast region of the USA, litter samples from regional commercial poultry houses and transport container swabs from processing facilities were cultured for Enterococcus spp. Using a microtiter plate adaptation of a conventional biochemical screen, the predominant species identfied were E. faecalis (61.2%), E. faecium (18.6%) and E. gallinarum (2.4%). Resistance to the cephalosporin, macrolide and tetracycline classes of antimicrobials was uniform with broader resistance to penicillin and derivatives present in a majority of E. faecium isolates. High-level streptomycin resistance was evident in close to 30% of all isolates with a majority of E. faecalis variants possessing resistance. High-level gentamicin resistance was detected at a low frequency (2.6%) only within the E. faecalis group with resistance to low-level gentamicin levels present in a majority of both the E. faecalis group and subsets of E. faecium. No unexpected vancomycin resistance was detected. Of particular interest was resistance to the streptogramin quinupristin-dalfopristin (Q-D or Synercid), which was present in 70.4% of E. faecium and E. faecium variants.

Animals↗

PubMed1986

Effect of imipenem-cilastatin therapy on fecal flora.

Alteration of fecal flora was prospectively studied in 21 children receiving imipenem-cilastatin therapy under protocol for therapy of infections. Although no profound reduction in facultative or anaerobic flora was observed, qualitative and quantitative increases in organisms which were resistant or less susceptible to imipenem occurred. Of 21 patients, 13 (62%) had increases in counts of Enterococcus spp. of at least 10(3) organisms per g (wet weight) of stool, and 7 (33%) had acquisition of or similar increases in counts of Candida species. No change in susceptibility of isolates to imipenem was demonstrable during therapy. However, the MICs for 50 and 90% of the strains of Enterococcus spp. (2 and 8 micrograms/ml, respectively) were higher than those previously reported.

Adolescent↗

PubMed2002

Geographic variations in garenoxacin (BMS284756) activity tested against pathogens associated with skin and soft tissue infections: report from the SENTRY Antimicrobial Surveillance Program (2000).

The antimicrobial activity of garenoxacin, a des-(6)F quinolone (formally BMS284756 and T-3811), was evaluated against 2,537 skin and soft tissue infection (SSTI) isolates from the SENTRY Antimicrobial Surveillance Program. Strains isolated in 2000 from Europe, North and Latin America were tested at a central laboratory using reference broth microdilution methods. The rank order of the seven most frequent SSTI pathogens was: Staphylococcus aureus (39.9%), Pseudomonas aeruginosa (12.1%), Escherichia coli (9.7%), Enterococcus spp. (7.7%), Klebsiella spp. (5.8%), Enterobacter spp. (5.6%) and coagulase-negative staphylococci (CoNS; 4.2%). Garenoxacin exhibited a four-fold greater activity (MIC(90), 0.06 microg/ml) compared to levofloxacin (MIC(90), 0.25 microg/ml) against oxacillin-susceptible S. aureus; and oxacillin-resistant staphylococci were more susceptible to garenoxacin (>/=90.5%) at </=4 microg/ml than ciprofloxacin or levofloxacin. Enterococcus spp. were more susceptible to garenoxacin and gatifloxacin (MIC(50), 0.5 microg/ml) than ciprofloxacin or levofloxacin (MIC(50), 2 microg/ml). All tested quinolones inhibited 64.7 to 69.7% of P. aeruginosa isolates, and the rank order of potency slightly favored ciprofloxacin (MIC(50), </=0.25 microg/ml). Similar susceptibility rates for the four quinolones were observed against E. coli (85.8-87.0%), Enterobacter spp. (90.8-94.3%) and Klebsiella spp. (89.8-95.2%) with the greatest levels of resistance recorded in Latin America for E. coli and Enterobacter spp. The occurrence of extended spectrum beta-lactamase-producing isolates (predominantly K. pneumoniae) was documented in all three monitored regions (Latin America > Europe > North America). Continued development of garenoxacin as a treatment of pathogens that commonly cause SSTIs appears to be warranted.

Anti-Infective Agents↗

PubMed2003

Multicentre evaluation of the in vitro activity of linezolid in the Western Pacific.

Multiresistance to antimicrobial agents is common in staphylococci and pneumococci isolates in the Western Pacific region. The activity of linezolid, a new oxazolidinone, was evaluated against a spectrum of Gram-positive species collected in the region. Eighteen laboratories from six countries in the Western Pacific examined the linezolid susceptibility of 2143 clinical isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS) and Enterococcus spp. using broth microdilution or disc diffusion methodology. For Streptococcus pneumoniae (n = 351) and other streptococci (n = 83), Etest (AB Biodisk, Solna, Sweden) strips were used. Results were compared with other common and important antimicrobials. Linezolid-resistant strains were not detected among streptococci or staphylococci, including a significant proportion of S. aureus strains that were multiresistant. Almost all enterococci, including 14 vancomycin-resistant Enterococcus faecium, were linezolid susceptible. A small proportion of enterococci (0.8%) were intermediate to linezolid, and one strain of Enterococcus faecalis had a zone diameter of 20 mm (resistant). The linezolid MIC ranges (MIC(90)) of those strains tested by broth microdilution or Etest were: 1-4 mg/L (2 mg/L) for S. aureus, 0.5-4 mg/L (2 mg/L) for CoNS, 0.5-4 mg/L (2 mg/L) for Enterococcus spp., 0.12-2 mg/L (1 mg/L) for S. pneumoniae and 0.25-2 mg/L (1 mg/L) for Streptococcus spp. There was no difference in linezolid susceptibility between countries or between multiresistant and susceptible strains of each species monitored.

Acetamides↗