[Activity of vancomycin, teicoplanin and linezolid in methicillin resistant coagulase-negative Staphylococci isolates from paediatric blood cultures]. / Actividad de vancomicina, teicoplanina y linezolid en Staphylococcus coagulasa-negativos resistentes a meticilina en aislados de hemocultivos pediátricos.

INTRODUCTION: Coagulase-negative-Staphylococci (CNS) are the major cause of bacteraemia and sepsis in newborns. CNS methicillin resistance and its loss of sensitivity to glycopeptide antibiotics, make treatment significantly more difficult in positive cocci infections. OBJECTIVE: To study MIC vancomycin, teicoplanin and linezolid in different species of CNS methicillin resistant isolates from blood cultures from paediatric patients. METHODS: Clinically relevant CNS methicillin resistant isolates from paediatric blood cultures from different hospitalization wards were tested. The isolates were identified by biochemical tests by means in the Combo panels 31 of MicroScan (Dade Behring, Siemens). Resistance to oxacillin and susceptibility to vancomycin, teicoplanin and linezolid were tested by microdilution panels as cited above. We also tested teicoplanin and linezolid sensitivity using Etest. RESULTS: 50 methicillin resistant strains were isolated: 37 (74%)S. epidermidis, 7 (14%) S. hominis, 4 (8%) S. haemolyticus and 2 (4%) Staphylococcus spp. 26 strains were observed with reduced susceptibility to vancomycin MIC = 2 mg/L, (22 S. epidermidis, 2 S. haemolyticus and 2 Staphylococcus spp.) and 21 strains with loss of susceptibility to teicoplanin, MIC = 4-16 mg/L (20 S. epidermidis and 1 S. haemolyticus). No CNS linezolid resistant was found. CONCLUSIONS: There is a linear correlation between increased vancomycin MIC and teicoplanin MIC. There is a statistically significant difference (p <0.001) in the MIC of teicoplanin in the vancomycin group = 2 mg/L with respect to the vancomycin group ≤ 1 mg/L. We also observed very low levels of linezolid MIC for all strains.

Actividad de vancomicina, teicoplanina y linezolid en Staphylococcus coagulasanegativos resistentes a meticilina en aislados de hemocultivos pediátricos / Activity of vancomycin, teicoplanin and linezolid in methicillin resistant coagulase-negative Staphylococci isolates from paediatric blood cultures

Introducción. Los Staphylococcus coagulasa negativos (ECN) son la principal causa de bacteriemia y sepsis en los recién nacidos. La resistencia meticilina y la pérdida de sensibilidad a glucopéptidos dificultan considerablemente el tratamiento antimicrobiano en infecciones por cocos grampositivos. Objetivos. Estudiar la CMI para vancomicina, teicoplanina y linezolid en diferentes especies de ECN meticilín resistentes aislados en hemocultivos procedentes de pacientes pediátricos. Métodos. Analizar los ECN resistentes a meticilina y clínicamente significativos, procedentes de hemocultivos de pacientes ingresados en diferentes Áreas del Servicio de Pediatría. Los aislamientos se identificaron mediante pruebas bioquímicas contenidas en los paneles Combo 31 de MicroScan (Dade Behring Siemens). La resistencia a oxacilina y la susceptibilidad frente a vancomicina, teicoplanina y linezolid se realizó mediante microdilución en placa contenida en los mismos paneles. Además se realizó Etest para teicoplanina y linezolid. Resultados. Se aislaron 50 cepas resistentes a meticilina: 37 (74%) S. epidermidis, 7 (14%) S. hominis, 4 (8%) S. haemolyticus y 2 (4%) Staphylococcus spp. Se observaron 26 cepas con sensibilidad disminuida para vancomicina, CMI de 2 mg/L, (22 S. epidermidis, 2 S. haemolyticus y 2 Staphylococcus spp.) y 21 cepas con disminución de sensibilidad a teicoplanina, CMI de 4-16 mg/L (20 S. epidermidis y 1 S. haemolyticus). Ningún ECN fue resistente a linezolid. Conclusiones. Existe una relación entre el aumento de CMI de vancomicina y el aumento de CMI de teicoplanina. Se observa una elevación estadísticamente significativa (p<0,001) en la CMI de teicoplanina en el grupo de vancomicina de 2 mg/L con respecto al grupo de vancomicina de ≤1 mg/L. Se observaron niveles muy bajos de CMI para linezolid en todas las cepas(AU)

Introduction. Coagulase-negative-Staphylococci (CNS) are the major cause of bacteraemia and sepsis in newborns. CNS methicillin resistance and its loss of sensitivity to glycopeptide antibiotics, make treatment significantly more difficult in positive cocci infections. Objective. To study MIC vancomycin, teicoplanin and linezolid in different species of CNS methicillin resistant isolates from blood cultures from paediatric patients. Methods. Clinically relevant CNS methicillin resistant isolates from paediatric blood cultures from different hospitalization wards were tested. The isolates were identified by biochemical tests by means in the Combo panels 31 of MicroScan (Dade Behring, Siemens). Resistance to oxacillin and susceptibility to vancomycin, teicoplanin and linezolid were tested by microdilution panels as cited above. We also tested teicoplanin and linezolid sensitivity using Etest. Results. 50 methicillin resistant strains were isolated: 37 (74%) S. epidermidis, 7 (14%) S. hominis, 4 (8%) S. haemolyticus and 2 (4%) Staphylococcus spp. 26 strains were observed with reduced susceptibility to vancomycin MIC = 2 mg/L, (22 S. epidermidis, 2 S. haemolyticus and 2 Staphylococcus spp.) and 21 strains with loss of susceptibility to teicoplanin, MIC = 4-16 mg/L (20 S. epidermidis and 1 S. haemolyticus). No CNS linezolid resistant was found. Conclusions. There is a linear correlation between increased vancomycin MIC and teicoplanin MIC. There is a statistically significant difference (p <0.001) in the MIC of teicoplanin in the vancomycin group = 2 mg/L with respect to the vancomycin group ≤ 1 mg/L. We also observed very low levels of linezolid MIC for all strains(AU)

Activity of vancomycin, ciprofloxacin, daptomycin, and linezolid against coagulase-negative staphylococci bacteremia.

OBJECTIVE: Multiresistant coagulase-negative staphylococci (CNS) infections are mainly increased in hospitalized patients. We have studied the activity of vancomycin, ciprofloxacin, daptomycin and linezolid in methicillin-resistant CNS strains, isolated from true blood cultures. METHODS: We collected 87 strains of different CNS species from positive blood cultures. Staphylococci were identified by MicroScan Walkaway (Dade Behring, Siemens) and with the Api ID 32 Staph (BioMerieux, France). The susceptibility to oxacillin, vancomycin and ciprofloxacin was performed by automatic microdilution plate as cited above. The susceptibility to daptomycin and linezolid was performed by Etest (AB BioMerieux, Solna, Sweden). Interpretative criteria were done following the CLSI guidelines. RESULTS: Eighty-seven CNS strains were studied: 55 (63%) were S. epidermidis, 15 (17%) S. haemolyticus, 10 (12%) S. hominis, and 7 (8%) other species. Fifty-three (61%) strains showed loss of susceptibility to vancomycin, MIC = 2 mg/L. Ciprofloxacin resistance, MIC > 2 mg/L, was observed in 56 (64%) strains. Daptomycin resistance was not observed, with a susceptibility range between 0.032-1 mg/L and modal value of 0.25 mg/L. Ten strains (11.5%) resistant to linezolid were observed. Nine patients were in ICU, where the average length of stay was 38 days (range 16-58 days) and one belonged to Hepato-Pancreatic Surgery, where he stayed for 64 days. CONCLUSIONS: Low susceptibility to vancomycin is frequent in the CNS strains studied in our hospital. Daptomycin shows a high efficacy against CNS, and it could be useful for the treatment of primary bacteremia or catheter associated bacteremia. The massive and continuous use of linezolid has led to the appearance of resistance.

Activity of vancomycin, ciprofloxacin, daptomycin and linezolid against coagulasenegative staphylococci bacteremia

Objetivo. Las infecciones por Staphylococcus coagulasa negativos (CNS) resistentes a meticilina aumentado considerablemente en los pacientes hospitalizados. Hemos estudiado la actividad de vancomicina, ciprofloxacino, daptomicina y linezolid en cepas de CNS resistente a meticilina aisladas en hemocultivos clínicamente significativos. Material y Métodos. Se estudiaron 87 cepas de distintas especies de CNS de hemocultivos positivos. Los estafilococos fueron identificados mediante el sistema automático MicroScan Walkaway (Dade Behring, Siemens) y con Api ID 32 Staph (Bio- Merieux, Francia). La sensibilidad a oxacilina, vancomicina y ciprofloxacino fue realizada por dicho sistema MicroScan. La susceptibilidad frente a daptomicina y linezolid fue realizada mediante Etest (AB BioMerieux, Solna, Suecia). Para los criterios de interpretación se siguieron las indicaciones del CLSI. Resultados. Se estudiaron 87 cepas, 55 (63%) fueron S. epidermidis, 15 (17%) fueron S. haemolyticus, 10 (12%) fueron S. hominis, y 7 (8%) pertenecieron a otras especies. 53 (61%) cepas presentaron una MIC para vancomicina de 2 mg/L. La resistencia a ciprofloxacino, MIC > 2 mg/L fue observada en 56 (64%) cepas. No se encontraron resistencia a daptomicina, con un rango de sensibilidad entre 0.032-1 mg/L y un valor modal de 0,25 mg/L. Se aislaron 10 (11,5%) cepas resistentes a linezolid. Nueve pacientes estuvieron ingresados en la Unidad de Cuidados Intensivos, donde la estancia media fue de 38 días (rango 16-58 días), y uno perteneció al Servicio de Cirugía Hepato-Pancreática, con una estancia de 64 días. Conclusiones. Es frecuente aislar cepas de CNS con pérdida de sensibilidad para vancomicina en nuestro hospital, mientras que daptomicina presenta una alta sensibilidad frente a este tipo de microorganismos. El uso masivo y continuado de linezolid ha llevado a la aparición de resistencias(AU)

Objective. Multiresistant coagulase-negative staphylococci (CNS) infections are mainly increased in hospitalized patients. We have studied the activity of vancomycin, ciprofloxacin, daptomycin and linezolid in methicillin-resistant CNS strains, isolated from true blood cultures. Methods. We collected 87 strains of different CNS species from positive blood cultures. Staphylococci were identified by MicroScan Walkaway (Dade Behring, Siemens) and with the Api ID 32 Staph (BioMerieux, France). The susceptibility to oxacillin, vancomycin and ciprofloxacin was performed by automatic microdilution plate as cited above. The susceptibility to daptomycin and linezolid was performed by Etest (AB BioMerieux, Solna, Sweden). Interpretative criteria were done following the CLSI guidelines. Results. Eighty-seven CNS strains were studied: 55 (63%) were S. epidermidis, 15 (17%) S. haemolyticus, 10 (12%) S. hominis, and 7 (8%) other species. Fifty-three (61%) strains showed loss of susceptibility to vancomycin, MIC = 2 mg/L. Ciprofloxacin resistance, MIC > 2 mg/L, was observed in 56 (64%) strains. Daptomycin resistance was not observed, with a susceptibility range between 0.032-1 mg/L and modal value of 0.25 mg/L. Ten strains (11.5%) resistant to linezolid were observed. Nine patients were in ICU, where the average length of stay was 38 days (range 16- 58 days) and one belonged to Hepato-Pancreatic Surgery, where he stayed for 64 days. Conclusions. Low susceptibility to vancomycin is frecuent in the CNS strains studied in our hospital. Daptomycin shows a high efficacy against CNS, and it could be useful for the treatment of primary bacteremia or catheter associated bacteremia. The massive and continuous use of linezolid has led to the appearance of resistance(AU)

Actividad de daptomicina, ciprofloxacino, clindamicina y cotrimoxazol frente a diferentes cepas de Staphylococcus coagulasa negativo con sensibilidad conservada y disminuida para vancomicina / Activity of daptomycin, ciprofloxacin, clindamycin and cotrimoxazole against coagulase-negative Staphylococcus strains with diminished susceptibility to vancomycin

Introducción. Los Staphylococcus coagulasa negativos(SCN) se han convertido en uno de los patógenos nosocomialesmás frecuentes y con una elevada tasa de mortalidad, debido ala mayor supervivencia de enfermos graves, estados deinmunosupresión prolongados y presencia de materialesextraños, como catéteres, prótesis, marcapasos, etc. Además,existe un importante aumento en las resistencias frente a losantimicrobianos, sobre todo betalactámicos, y se hadocumentado cómo el incremento en la CMI para vancomicinaconlleva una pérdida de su eficacia clínica, por lo que se buscannuevas alternativas terapéuticas, como daptomicina.El objetivo de este trabajo es estudiar la actividad dedaptomicina, ciprofloxacino, clindamicina y cotrimoxazol endos grupos de SCN clínicamente significativos, uno con CMI90para vancomicina ≤ 1 mg/L y el otro con CMI90 de 2 mg/L.Métodos. Se identificaron y estudiaron las CMI90 paraciprofloxacino, clindamicina y cotrimoxazol de 54 cepas de SCNclínicamente significativos mediante los paneles combo 22 deMicroScan (Dade behring, Siemens). La CMI90 para daptomicinase realizó mediante Etest (AB BioMèrieux, Solna, Suecia) enplacas de Mueller Hinton (BioMèrieux, Francia).Resultados. En el Grupo I (CMI90 para vancomicina ≤ 1mg/L) se estudiaron 19 cepas y en el Grupo II (CMI90 paravancomicina = 2 mg/L) se estudiaron 35 cepas. Expresadas enmg/L, los rangos de CMI90 para daptomicina fueron 0.047-0.5en el Grupo I y 0,064-0,5 en el Grupo II. Para ciprofloxacinohubo 8 cepas sensibles y 11 resistentes en el Grupo I y 10sensibles y 25 resistentes en el Grupo II. Para clindamicina hubo7 cepas sensibles y 12 resistentes en el Grupo I y 16 sensibles y19 resistentes en el Grupo II. Finalmente, Para cotrimoxazolhubo 10 cepas sensibles y 9 resistentes en el Grupo I y 19sensibles y 16 resistentes en el Grupo II...(AU)

Introduction. Coagulase Negative Staphylococci (CNS)have become one of the most common nosocomial pathogensand it has a high mortality rate due to the increased ofseriously ill patients survival, long states immunosuppressionand presence of foreign bodies, such as catheters, prostheses,pacemakers, etc. In addition, there is a significant increase inresistance to antimicrobial drugs, especially beta-lactams, andthe increase in the MIC for vancomycin leads to a loss ofclinical efficacy. This necessitates the search for newtherapeutic alternatives, such as daptomycin.The aim of this paper is to study the activity ofdaptomycin, ciprofloxacin, clindamycin and cotrimoxazole intwo groups of clinically significant CNS. a MIC90 withvancomycin ≤ 1 mg/L and the other with MIC90 2 mg/L.Methods. We identified and studied MIC90 tociprofloxacin, clindamycin and cotrimoxazole from 54 strainsof clinically significant by the CNS Combo 22 Microscan panels(Dade Behring, Siemens). The MIC90 for daptomycin wasperformed using Etest (AB BioMérieux, Solna, Sweden) onMueller Hinton plates (BioMérieux, France).Results In Group I (vancomycin MIC90 ≤ 1 mg/L) were 19 strains whereas in Group II (vancomycin MIC90 = 2 mg/L) were35 strains. Expressed in mg/L, MIC90 ranges for daptomycinwere 0.047-0.5 in Group I and 0.064-0.5 in Group II. Forciprofloxacin were 8 sensitive strains and 11 resistant in GroupI and 10 sensitive and 25 resistant in Group II. For clindamycinwere 7 sensitive strains and 12 resistant in Group I and 16sensitive and 19 resistant in Group II. Finally, for cotrimoxazolewere 10 sensitive strains and 9 resistant in Group I and 19sensitive and 16 resistant in Group II...(AU)