RESUMO
Gepotidacin inhibits bacterial DNA replication through a mode different from that of fluoroquinolones. Gepotidacin and comparators were tested by broth and agar dilution against clinical isolates. The in vitro activities of gepotidacin were comparable against methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA, respectively) isolates (MIC90, 0.5 µg/ml). The gepotidacin MIC90s were as follows (in micrograms per milliliter) for the indicated bacteria: Streptococcus pyogenes, 0.25; Escherichia coli, 2; Moraxella catarrhalis, ≤ 0.06; Streptococcus pneumoniae (0.25), Haemophilus influenzae, 1; Clostridium perfringens, 0.5; and Shigella spp., 1, including levofloxacin-resistant subsets. Gepotidacin warrants further investigation for clinical development.
Assuntos
Acenaftenos/farmacologia , Antibacterianos/farmacologia , Replicação do DNA/efeitos dos fármacos , Compostos Heterocíclicos com 3 Anéis/farmacologia , Inibidores da Topoisomerase II/farmacologia , Clostridium perfringens/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Escherichia coli/efeitos dos fármacos , Haemophilus influenzae/efeitos dos fármacos , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Moraxella catarrhalis/efeitos dos fármacos , Shigella/efeitos dos fármacos , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pyogenes/efeitos dos fármacosRESUMO
OBJECTIVES: Ceftaroline fosamil is indicated for the treatment of community-acquired bacterial pneumonia and ceftriaxone has an indication for lower respiratory tract infections. This study was conducted to compare the relative in vitro activities of these two agents against bacterial species associated with community-associated respiratory tract infections. METHODS: In all, 13â005 isolates of Staphylococcus aureus, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae were collected in 2012-14 from 39 countries in the Asia-Pacific region, Europe, Latin America and Africa-Middle East from respiratory tract specimens. The identification was confirmed centrally by MALDI-TOF and broth microdilution susceptibility testing and interpretation was done according to CLSI guidelines. RESULTS: Ceftaroline was 16-fold more potent against MSSA (MIC90 0.25 versus 4 mg/L) than ceftriaxone and ≥16-fold more potent against MRSA (MIC90 2 versus >32 mg/L). Ceftaroline was 16-fold more potent against S. pneumoniae (MIC90 0.12-0.25 mg/L) compared with ceftriaxone (MIC90 1-2 mg/L), with higher MIC values observed among penicillin-non-susceptible isolates for both agents. Similar activity (MIC90 ≤0.03 mg/L) was observed for ceftaroline and ceftriaxone against H. influenzae, with higher MIC values observed in the Asia-Pacific region for both agents compared with other regions. Ceftaroline was 4- to 8-fold more active against M. catarrhalis (MIC90 0.12-0.25 mg/L) compared with ceftriaxone (MIC90 1 mg/L). CONCLUSIONS: These global MIC data demonstrated that ceftaroline exhibited superior in vitro activity compared with ceftriaxone against bacterial species that commonly cause community-associated respiratory tract infections.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/microbiologia , Ceftriaxona/farmacologia , Cefalosporinas/farmacologia , Infecções Respiratórias/microbiologia , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Bactérias/isolamento & purificação , Infecções Comunitárias Adquiridas/microbiologia , Monitoramento Epidemiológico , Feminino , Saúde Global , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , CeftarolinaRESUMO
Tedizolid is an oxazolidinone with an antimicrobial in vitro potency advantage against Gram-positive bacterial pathogens compared to other currently marketed drugs in this class, including linezolid. Tedizolid was compared to linezolid when tested against Staphylococcus aureus and Streptococcus pneumoniae isolates collected from countries in Latin America and the Asia-Pacific. Isolates were tested by broth microdilution susceptibility methods against tedizolid, linezolid, and non-class comparators in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines. The activity of tedizolid against S. aureus was potent and consistent in Latin America (MIC90, 0.5 mg/L), Australia and New Zealand (MIC90, 0.25 mg/L), and China (MIC90, 0.5 mg/L). Based on MIC90 results, tedizolid was four- to eight-fold more active than linezolid against S. aureus, including both methicillin-susceptible and -resistant isolates. Only two tedizolid non-susceptible strains were observed; both had intermediate minimum inhibitory concentration (MIC) values of 1 mg/L, for which the MICs of linezolid was higher (≥2 mg/L). Tedizolid (MIC90, 0.25 mg/L) was four-fold more potent than linezolid (MIC90, 1 mg/L) against S. pneumoniae in all countries that provided isolates. The findings from this study support the global clinical development of tedizolid for Gram-positive infections.
Assuntos
Antibacterianos/farmacologia , Organofosfatos/farmacologia , Oxazóis/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , Australásia , China , Humanos , América Latina , Linezolida/farmacologia , Testes de Sensibilidade MicrobianaRESUMO
Clinical development of CEM-102 (fusidic acid) has recently begun in the United States for chronic oral treatment of prosthetic joint infections. To support this development, the in vitro activity of fusidic acid against important Staphylococcus aureus clones and resistance phenotypes was determined. Against 51 such isolates, the modal fusidic acid MIC was 0.12 µg/ml (range, 0.06 to 0.25 µg/ml for 49 isolates). This level of in vitro fusidic acid activity underscores the potential clinical utility of this compound in the United States.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Ácido Fusídico/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Meios de Cultura , Testes de Sensibilidade Microbiana , Fenótipo , Staphylococcus aureus/crescimento & desenvolvimentoRESUMO
Surveillance initiatives to track Streptococcus pneumoniae resistance trends are important for understanding the current in vitro effectiveness of available antimicrobial agents. The antimicrobial susceptibility profiles of S. pneumoniae (n=1479 isolates) collected from 17 geographical areas across the USA (2003-2004) were analysed; 36.8% of isolates were resistant to one or more agents (24.4% were multidrug-resistant, i.e. resistant to two or more antimicrobial classes). Multidrug resistance involved resistance to beta-lactams, macrolides, tetracycline and trimethoprim/sulphamethoxazole, but rarely fluoroquinolones (>96% of multidrug-resistant isolates were fluoroquinolone-susceptible). Multidrug resistance rates were prominent regardless of the geographical region surveyed. As this trend continues, the empirical therapeutic options for S. pneumoniae infections will diminish and there will be an ongoing need to evaluate the effectiveness of potent fluoroquinolones such as gemifloxacin.
Assuntos
Antibacterianos/farmacologia , Infecções Comunitárias Adquiridas/epidemiologia , Farmacorresistência Bacteriana Múltipla , Pneumonia Pneumocócica/epidemiologia , Vigilância da População/métodos , Streptococcus pneumoniae/efeitos dos fármacos , Infecções Comunitárias Adquiridas/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Pneumonia Pneumocócica/microbiologia , Estados Unidos/epidemiologiaRESUMO
The clinical microbiology laboratory is strategically positioned to recognize changing patterns in bacterial resistance to antimicrobials. This requires the application of accurate testing methods and a methodological survey of drug-resistance patterns among clinically important bacteria. This information can be assembled into comprehensive international databases, using a common format to facilitate monitoring.
Assuntos
Resistência Microbiana a Medicamentos , Monitoramento Ambiental/métodos , Exposição Ambiental , Laboratórios , Testes de Sensibilidade Microbiana/métodos , Testes de Sensibilidade Microbiana/normas , Microbiologia , Resistência beta-LactâmicaRESUMO
Intensive care units (ICUs) are often described as hotbeds of antimicrobial resistance, with high rates of extended-spectrum ß-lactamase (ESBL)-producing and multidrug-resistant (MDR) Enterobacteriaceae. Data from the SMART study were used to examine differences between the susceptibility of Enterobacteriaceae from ICU and non-ICU wards in Europe and North America. In total, 21,470 Enterobacteriaceae isolates from intra-abdominal and urinary tract infections were collected at 90 sites in 20 European and North American countries in 2011-2013. Susceptibility and ESBL phenotypes were determined using the CLSI broth microdilution method and breakpoints. Susceptibility was lower and ESBL and MDR rates were higher in ICUs, with much greater ICU/non-ICU differences in Europe than North America. Susceptibility was lower and ESBL and MDR rates were higher in Europe than in North America in both patient locations. Resistance among Enterobacteriaceae in Europe was largely driven by Klebsiella pneumoniae, which had high rates of ESBLs (41.2% in ICUs; mostly CTX-M) and carbapenemases (13.2%; mostly KPC and OXA). For all Enterobacteriaceae combined, only ertapenem and amikacin inhibited >90% of isolates in ICUs in both regions. In North America, ertapenem, imipenem and amikacin inhibited >90% of K. pneumoniae from ICUs, whereas in Europe only amikacin did. ESBL and MDR rates varied considerably within Europe. Antimicrobial resistance was higher in Europe than North America, especially in ICUs. Further surveillance at the country, hospital and even patient ward level, and investigation of reasons for these findings, would be useful for the development of effective strategies to reduce antimicrobial resistance in ICUs.
RESUMO
We report the cloning and sequencing of a 632-bp amplified fragment internal to the vanB gene of vancomycin-resistant (VmR) Enterococcus (En.) faecalis V583. The DNA fragment hybridized to VmR strains of En. faecium and En. faecalis, but not to their susceptible derivatives.
Assuntos
Proteínas de Bactérias/genética , Carbono-Oxigênio Ligases , Resistência Microbiana a Medicamentos/genética , Enterococcus faecalis/genética , Genes Bacterianos , Peptídeo Sintases/genética , Vancomicina/farmacologia , Sequência de Aminoácidos , Sequência de Bases , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/enzimologia , Glicopeptídeos/farmacologia , Dados de Sequência Molecular , Homologia de Sequência de AminoácidosRESUMO
OBJECTIVE: To identify independent risk factors for enteric carriage of vancomycin-resistant Enterococcus faecium (VREF) in hospitalized patients tested for Clostridium difficile toxin. DESIGN: Retrospective case-cohort study. SETTING: Tertiary-care teaching hospital. PATIENTS: Convenience sample of 215 adult inpatients who had stool tested for C difficile between January 29 and February 25, 1996. RESULTS: 41 (19%) of 215 patients had enteric carriage of VREE Five independent risk factors for enteric VREF were identified: history of prior C difficile (odds ratio [OR], 15.21; 95% confidence interval [CI95], 3.30-70.10; P < .001), parenteral treatment with vancomycin for > or = 5 days (OR, 4.06; CI95, 1.54-10.73; P = .005), treatment with antimicrobials effective against gram-negative organisms (OR, 3.44; CI95, 1.20-9.87; P = .021), admission from another institution (OR, 2.95; CI95, 1.21-7.18; P =.017), and age > 60 years (OR 2.57; CI95, 1.13-5.82; P = .024). These risk factors for enteric VREF were independent of the patient's current C difficile status. CONCLUSIONS: Antimicrobial exposures are the most important modifiable independent risk factors for enteric carriage of VREF in hospitalized patients tested for C difficile.
Assuntos
Portador Sadio/microbiologia , Infecção Hospitalar/microbiologia , Enterococcus faecium/isolamento & purificação , Infecções por Bactérias Gram-Positivas/microbiologia , Resistência a Vancomicina , Adulto , Idoso , Antibacterianos/uso terapêutico , Portador Sadio/epidemiologia , Estudos de Casos e Controles , Clostridioides difficile/isolamento & purificação , Infecção Hospitalar/epidemiologia , Reservatórios de Doenças/estatística & dados numéricos , Fezes/microbiologia , Feminino , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Missouri/epidemiologia , Prevalência , Estudos Retrospectivos , Estatística como AssuntoRESUMO
Two hundred ninety-five endocervical swab specimens were obtained from patients presenting to a gynecology clinic in order to compare a nonradioactive chemiluminescent DNA probe with cell culture for detection of Chlamydia trachomatis. Discrepancies between cell culture and DNA probe were resolved by retesting and reculturing samples. In a population with a 10.8% prevalence, the corrected sensitivity, specificity, positive predictive value, and negative predictive value for the DNA probe were 80.6, 95.8, 71.4, and 97.3%, respectively. These results compare favorably to other non-culture methods such as direct fluorescent antibody and enzyme immunoassay tests for the detection of C trachomatis in populations with similar prevalence rates.
Assuntos
Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , DNA Bacteriano/análise , Programas de Rastreamento/métodos , Cervicite Uterina/microbiologia , Células Cultivadas , Sondas de DNA , Feminino , Humanos , Medições Luminescentes , Valor Preditivo dos TestesRESUMO
Effective surveillance of antimicrobial-resistant bacteria is important for developing rational empiric therapy guidelines and for guiding public health efforts to control and prevent the spread of infective agents. Surveillance must include a timely and thorough review of the test results generated in clinical microbiology laboratories because this data serves as the core of surveillance activities. Besides ensuring data accuracy and optimizing detection of emerging resistance, the role of clinical microbiology also includes supporting the production of informative surveillance reports, providing laboratory resources for outbreak investigations, and monitoring the performance of commonly used susceptibility testing methods. Once the accuracy of susceptibility results has been validated, the data are used by public health agencies and professional societies to monitor resistance trends on a local, state, national, and international level. This information is also used to develop policies for prudent antimicrobial use locally and nationally.
Assuntos
Antibacterianos/farmacologia , Coleta de Dados , Resistência Microbiana a Medicamentos , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Centers for Disease Control and Prevention, U.S. , Microbiologia de Alimentos , Saúde Global , Órgãos Governamentais , Planejamento em Saúde , Humanos , Laboratórios , Microbiologia , Vigilância da População , Saúde Pública , Regionalização da Saúde , Estados UnidosRESUMO
The influence of culture medium on in vitro of selected cephalosporins on on group D streptococci was investigated by agar diffusion and broth dilution methods. The activity of cephalothin, cefamandole, and cefoperazone were not substantially influenced by the type of culture medium used, but cefuroxime, ceftizoxime, cefotaxime (CTX), cefmenoxime, and ceftriaxone varied markedly with both the commercial brand and the blood content of the broth used. The differences were more likely to occur in some Mueller-Hinton media, particularly when supplemented with 5% lysed sheep blood, and resulted in susceptible results instead of the resistant results that were obtained with these same media without blood. Some strains of Streptococcus faecalis showed these discrepancies, but S. bovis did not. The influence of the media on in vitro activity suggests a complex interaction between some cephalosporins, media components, and organisms. The cephalosporins that were affected by media share an identical moiety at the 7-acyl position (cefuroxime is slightly different); this structure is not shared by those cephalosporins that were not affected, however. It is possible that this structure may play a part in the phenomenon.
Assuntos
Sangue , Cefalosporinas/farmacologia , Meios de Cultura , Streptococcus/efeitos dos fármacos , Animais , Enterococcus faecalis/efeitos dos fármacos , Testes de Sensibilidade Microbiana/métodos , Testes de Sensibilidade Microbiana/normasRESUMO
To decrease the time needed to obtain preliminary antimicrobial susceptibility results with blood culture isolates, we inoculated a suspension of centrifuged organisms from blood culture broth directly into the AutoMicrobic System Gram-Positive (GPS) and Gram-Negative (GSC+) susceptibility cards (AMS, Vitek Systems Inc., Hazelwood, MO). Interpretive category results (susceptible, moderately susceptible, resistant) obtained by this direct method (DAMS) were then compared with results obtained by conventional inoculation (i.e., using 18-hr subcultures) of both AMS cards (CAMS method) and broth microdilution panels (MIC method, Micro-Media Systems Inc., Potomac, MD). Ninety-six Gram-positive cocci (951 antimicrobial agent--organism combinations) and 112 Gram-negative bacilli (1006 antimicrobial agent-organism combinations) were tested. When only very major (false susceptible DAMS results) and major (false resistant DAMS results) discrepancies were considered, 95% of the DAMS results for Gram-positive cocci agreed with CAMS results and 93% agreed with MIC results. Most discrepancies were observed when staphylococci were tested against oxacillin and when enterococci were tested against several antimicrobial agents. For Gram-negative bacilli, 94% of DAMS results agreed with CAMS results and 93% agreed with MIC results. Most discrepancies occurred when Enterobacter spp. and Serratia marcescens were tested against ampicillin and cefamandole. The DAMS method provides accurate and rapid preliminary susceptibility test results, usually within 6 to 7 hr of the time a positive blood culture is first detected.
Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Sepse/microbiologia , Reações Falso-Positivas , Humanos , Testes de Sensibilidade Microbiana/instrumentação , Testes de Sensibilidade Microbiana/métodos , Sepse/tratamento farmacológicoRESUMO
Enterococci with gentamicin MICs of 256 to 1,024 micrograms/mL were evaluated for susceptibility to ampicillin plus gentamicin synergism. Sixteen of eighteen enterococcal isolates were not susceptible to synergistic killing by ampicillin plus gentamicin; 11 possessed aac(6')-aph(2"), and 4 possessed aph(2")-Ic. A gentamicin MIC of 512 or 1,024 micrograms/mL predicted lack of ampicillin/gentamicin synergism, but a gentamicin MIC of 256 micrograms/mL did not. For six enterococcal strains possessing the gentamicin-resistance gene aph(2")-Ic, ampicillin plus dibekacin, ampicillin plus netilmicin, and ampicillin plus amikacin produced synergistic killing in five, three, and two strains, respectively.
Assuntos
Ampicilina/farmacologia , Enterococcus faecium/efeitos dos fármacos , Gentamicinas/farmacologia , Penicilinas/farmacologia , Amicacina/farmacologia , Amicacina/uso terapêutico , Ampicilina/uso terapêutico , Animais , Primers do DNA/química , Sondas de DNA/química , Enzimas de Restrição do DNA , Dibecacina/farmacologia , Dibecacina/uso terapêutico , Resistência Microbiana a Medicamentos/genética , Sinergismo Farmacológico , Eletroforese em Gel de Ágar , Enterococcus faecium/genética , Gentamicinas/uso terapêutico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Netilmicina/farmacologia , Netilmicina/uso terapêutico , Penicilinas/uso terapêutico , Reação em Cadeia da PolimeraseRESUMO
To benchmark the activity of moxifloxacin, a European study comprising 900 Streptococcus pneumoniae, 1051 Haemophilus influenzae, and 226 Moraxella catarrhalis referred from 30 institutions during 1998 is described. For S. pneumoniae, moxifloxacin and trovafloxacin MIC(90) and modal MICs values were 0.12 microg/ml and independent of susceptibility to other drug classes, geography, or site of infection. MIC(90)/modal MICs were, respectively, 0.25/0.12 microg/ml for grepafloxacin, 0.25/0.25 microg/ml for sparfloxacin, and 1.0/0.5 microg/ml for levofloxacin. The moxifloxacin C(max):MIC ratio of 20.8-26.3 is higher than comparator fluoroquinolones. Five isolates were intermediate or resistant to grepafloxacin, sparfloxacin, or levofloxacin of which four and three remained susceptible to trovafloxacin and moxifloxacin, respectively. For moxifloxacin, > 90% of S. pneumoniae isolates demonstrated MICs > or =3 dilutions below the susceptibility breakpoint used. Modal MICs and MIC(90) for M. catarrhalis (both 0.03 microg/ml) and H. influenzae (0.03 microg/ml and 0.06 microg/ml) were independent of beta-lactamase production. These data demonstrate the in vitro activity of moxifloxacin and establish a baseline for future surveillance studies that will be important for detecting and tracking any trends in changing activity of this fluoroquinolone.
Assuntos
Anti-Infecciosos/farmacologia , Compostos Aza , Fluoroquinolonas , Haemophilus influenzae/efeitos dos fármacos , Moraxella catarrhalis/efeitos dos fármacos , Quinolinas , Streptococcus pneumoniae/efeitos dos fármacos , DNA Girase , DNA Topoisomerase IV , DNA Topoisomerases Tipo II/metabolismo , Resistência Microbiana a Medicamentos , Europa (Continente) , Haemophilus influenzae/enzimologia , Haemophilus influenzae/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Moraxella catarrhalis/enzimologia , Moraxella catarrhalis/isolamento & purificação , Moxifloxacina , Streptococcus pneumoniae/enzimologia , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
Strains of Streptococcus pneumoniae from the United States that were susceptible, intermediately resistant, or highly resistant to penicillin were tested for susceptibility to 26 antimicrobial agents that have been used or considered for the treatment of patients with pneumococcal infections. The drugs tested included penicillins, one penicillin/beta-lactamase inhibitor combination, cephalosporins, macrolides, a lincosamide, fluoroquinolones, and four miscellaneous drugs (vancomycin, rifampin, tetracycline, and trimethoprim-sulfamethoxazole). The activities of the penicillins and macrolide agents were similar, but the activities within the cephalosporin and fluoroquinolone classes were often dissimilar. For the fluoroquinolones, the order of in vitro activity, from most to least active, was grepafloxacin, sparfloxacin, levofloxacin, ciprofloxacin, and ofloxacin. Increased resistance to penicillin in the pneumococcal isolates studied correlated with increased resistance to other penicillins, cephalosporins, macrolides, clindamycin, tetracycline, and trimethoprim-sulfamethoxazole but did not correlate with increased resistance to the fluoroquinolones, rifampin, or vancomycin. These findings may be helpful to health professionals selecting empiric therapy for respiratory tract infections involving S. pneumoniae.
Assuntos
Anti-Infecciosos/farmacologia , Fluoroquinolonas , Resistência às Penicilinas , Piperazinas/farmacologia , Quinolonas/farmacologia , Streptococcus pneumoniae/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Infecções Estreptocócicas/microbiologiaRESUMO
OBJECTIVE: To assess the ability of 59 clinical microbiology laboratories distributed throughout Italy to correctly identify and detect reduced susceptibility to glycopeptides in staphylococci and VanA-, VanB- or VanC-mediated glycopeptide resistance in enterococci. METHODS: Eight test strains comprising three staphylococci (S. aureus ATCC 29212 and two vancomycin-intermediate S. haemolyticus [11105301, 10030683Y]) and five enterococci (E. faecalis ATCC 29212, E. faecalis ATCC 51299 VanB, E. faecium AIB40 VanA, E. faecalis V583 VanB and E. gallinarum AIB39 VanC1) were distributed to 59 Italian clinical microbiology laboratories. Each isolate was blind-coded, and laboratories were instructed to identify the strains and test isolates for susceptibility to teicoplanin and vancomycin using their standard methods. Results were assessed against consensus test results obtained by a reference laboratory. In addition, to complement data interpretation, laboratories were asked to provide retrospective routine test results from their respective hospitals. RESULTS: All 59 laboratories participating in the study completed the susceptibility testing and provided data for analysis. A total of 53 laboratories provided retrospective routine data. Overall, laboratories were able to identify isolates to the genus level successfully. E. gallinarum and S. haemolyticus posed problems for species identification, with only 40.6 and 71.2%, respectively, of results reported correctly; most incorrect results were reported as 'other species'. For enterococcal test strains, VanA phenotypes were detected correctly by 96.6% of laboratories; VanB by 30.5% (E. faecalis ATCC 51299) and 88.1% (E. faecalis V583); and VanC1 by 67.8%. For staphylococcal test strains, 28.8% (S. haemolyticus 11105301) and 23.7% (S. haemolyticus 10030683Y) of the laboratories were able to detect reduced susceptibility to vancomycin. Errors in detecting vancomycin resistance in VanB and VanC1 enterococci were made with all methods, most noticeably by disk diffusion users. For staphylococci, most errors in reporting vancomycin-intermediate resistance occurred with disk diffusion and Vitek (software version 5.04) users. Overall, considerably fewer errors occurred with the detection of teicoplanin resistance, especially for staphylococci. For 1999, routine results show that 41/1749 (2.4%) of E. faecium, 220/11 180 (2.0%) of E. faecalis, 29/24 927 (0.12%) of S. aureus and 54/22 102 (0.24%) of coagulase-negative staphylococci were reported as resistant to vancomycin. CONCLUSION: Italian laboratories are able to identify staphylococci and enterococci adequately, although all methodologies used have problems in identifying E. gallinarum and coagulase-negative staphylococci to the species level. While VanA phenotypes were efficiently detected, problems were experienced in detecting VanB and VanC phenotypes. The majority of laboratories were unable to detect reduced vancomycin susceptibility in staphylococci adequately, especially with disk diffusion and older Vitek systems. Teicoplanin appeared useful as a marker for detecting vancomycin resistance, particularly with disk diffusion. Should enterococcal VanB or staphylococcal glycopeptide-intermediate phenotypes become prevalent in Italy, it is likely that they would be under-detected. New systems under development, such as Vitek2, should improve this situation.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Enterococcus/efeitos dos fármacos , Testes de Sensibilidade Microbiana/normas , Staphylococcus/efeitos dos fármacos , Difusão , Enterococcus/classificação , Enterococcus/isolamento & purificação , Hospitais , Itália , Controle de Qualidade , Sensibilidade e Especificidade , Staphylococcus/classificação , Staphylococcus/isolamento & purificação , Teicoplanina/farmacologia , Vancomicina/farmacologia , Resistência a VancomicinaRESUMO
Bacillus anthracis is a bacterial species that could be used in a bioterrorist attack. We tested a collection of isolates with a range of relevant antimicrobial compounds. All isolates tested were susceptible to ciprofloxacin and doxycycline. Penicillin and amoxicillin, with or without clavulanate, showed in vitro activity against all B. anthracis isolates. Ceftriaxone demonstrated lower-level in vitro activity compared to penicillin-related compounds against B. anthracis. In vitro data from this study are in keeping with available guidelines.
Assuntos
Antibacterianos/farmacologia , Bacillus anthracis/efeitos dos fármacos , Bioterrorismo , Ciprofloxacina/farmacologia , Antraz/microbiologia , Bacillus anthracis/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Esporos Bacterianos/metabolismoRESUMO
In 2000-2001, 840 clinical isolates of Haemophilus influenzae were collected from laboratories in France, Germany, Italy and Spain (210 isolates/country). Beta-Lactamase production among the isolates varied considerably by country, ranging from 8.1% in Germany to 34.8% in France. H. influenzae from patients
Assuntos
Antibacterianos/farmacologia , Haemophilus influenzae/efeitos dos fármacos , Europa (Continente)/epidemiologia , Infecções por Haemophilus/diagnóstico , Haemophilus influenzae/enzimologia , Haemophilus influenzae/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Estudos Prospectivos , beta-Lactamases/biossínteseRESUMO
OBJECTIVE: To assess the current (2001) activity of respiratory fluoroquinolones and comparator agents against respiratory pathogens isolated in European countries. METHODS: During 2000-2001, we prospectively collected 1995 isolates of Haemophilus influenzae, 1870 isolates of Streptococcus pneumoniae and 649 isolates of Moraxella catarrhalis from hospital laboratories in France, Germany, Greece, Italy, Spain and the UK. National Committee for Clinical Laboratory Standards (NCCLS)-approved broth microdilution antimicrobial susceptibility testing methods and interpretive criteria were used throughout. RESULTS: Of the S. pneumoniae isolates, 99.6% were susceptible to moxifloxacin, gatifloxacin and levofloxacin; the corresponding figure for H. influenzae was 100%. All M. catarrhalis isolates had moxifloxacin MICs = 0.12 mg/L. For all three pathogens, fluoroquinolone susceptibility remained unchanged from the previous 1997-98 study. The incidence of penicillin non-susceptibility in the S. pneumoniae isolates tested remained similar to or higher than that recorded in previous studies: France, 165/291 (56.7%); Germany, 46/506 (9.1%); Greece, 20/55 (36.4%); Italy, 45/364 (12.4%); Spain, 146/268 (54.5%); and the UK, 26/386 (6.7%). Significant levels of resistance to oral compounds (cefuroxime, cefaclor, cefdinir, clarithromycin, azithromycin, tetracycline, and trimethoprim-sulfamethoxazole) were detected among S. pneumoniae isolates. beta-Lactamase production among H. influenzae isolates ranged from 6.2% to 33.1% per country, and ampicillin, clarithromycin or trimethoprim-sulfamethoxazole resistance were the most common phenotypes detected. beta-Lactamase production among M. catarrhalis isolates ranged from 94.1% to 100% per country. CONCLUSIONS: With the exception of a few localized reports, resistance to moxifloxacin and other new fluoroquinolones in common respiratory pathogens is a rare occurrence, despite significant resistance to other compound classes. Surveillance will play a key role in tracking changes in fluoroquinolone susceptibility in European countries.