Activity of linezolid and tedizolid against clinical isolates of methicillin-resistant and methicillin and linezolid resistant Staphylococcus aureus: an in vitro comparison.

OBJECTIVE: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Spain is approximately 20-30%. However, resistance to linezolid is rare, and the main reports are from nosocomial outbreaks. The objective of the present study was to compare the in vitro susceptibility of linezolid with that of tedizolid against MRSA isolates and methicillin-and linezolid-resistant isolates (MLRSA) mediated by the cfr gene. METHODS: The in vitro susceptibility of linezolid and tedizolid was determined using the E-test with 18 MRSA strains and 18 cfr-mediated MLRSA strains obtained from clinical isolates in the microbiology service of a tertiary university hospital. RESULTS: All MRSA strains were susceptible to both antibiotics. Analysis of the MRSA isolates revealed that the MIC50 and MIC90 of linezolid were 1.5 and 2 mg/L, respectively; those of tedizolid were 0.25 and 0.4 mg/L. The MIC50 and MIC90 of tedizolid remained at 0.75 and 1 mg/L against the MLRSA strains (MIC90 ≥ 8 mg/L). CONCLUSIONS: Both for MRSA and for MLRSA, the MICs obtained for tedizolid were at least 2 dilutions lower than those of linezolid, thus demonstrating between 2 and 4 times greater activity in vitro than linezolid.

[Renal infarction and kidney rupture: complication of a massive cocaine intoxication in an intestinal carrier]. / Infarto y rotura renales: complicación de intoxicación masiva por cocaína en un portador intestinal.

Major complications derived from the use of cocaine have been described, alter nasal or intravenous administration of the drug. These complications are related to vascular spasm and secondary organ damage. We present the case of an intestinal cocaine packer--in slang, "mule"--, who suffered massive absorption of the drug, resulting n bowel, liver and renal ischemia. This situation, previously undescribe in the literature, ended in kidney rupture. An attempt of embolization, was unsatisfactory, and nephrectomy was finally required. The patient recovered uneventfully, with progressive renal functional improvement. This case, albeit quite exceptional, is illustrative of several of the renal actions of cocaine, and reveals the effects of absorption of cocaine at the intestinal level.

Infarto y rotura renales: complicación de intoxicación masiva por cocaína en un portador intestinal / Renal infarction and kidney rupture: complication of a massive cocaine intoxication in an intestinal carrier

Las complicaciones derivadas del uso de la cocaína se han descrito casi exclusivamente tras la administración por vía intranasal o intravenosa, y se relacionan con cuadros de espasmo vascular y daño de órganos secundario al mismo. Se presenta el caso de un portador intestinal de cocaína -coloquialmente, «bolero » o «mula», que sufre absorción de la droga con resultado de isquemia intestinal, hepática y renal. Esta situación, previamente no descrita en la literatura, cursó con rotura del riñón y hemorragia masiva intraabdominal. Tras un intento de embolización, sin resultado satisfactorio, se realizó una nefrectomía. El paciente recuperó función renal dentro de los límites predecibles. Este caso, aunque producto de una situación excepcional, ilustra varias de las acciones renales de la cocaína y revela los efectos de su absorción a nivel intestinal

Major complications derived from the use of cocaine have been described, alter nasal or intravenous administration of the drug. These complications are related to vascular spasm and secondary organ damage. We present the case of an intestinal cocaine packer -in slang, «mule»-, who suffered massive absorption of the drug, resulting in bowel, liver and renal ischemia. This situation, previously undescribe in the literature, ended in kidney rupture. An attempt of embolization, was unsatisfactory, and nephrectomy was finally required. The patient recovered uneventfully, with progressive renal functional improvement. This case, albeit quite exceptional, is illustrative of several of the renal actions of cocaine, and reveals the effects of absortion of cocaine at the intestinal level