Background
Levonadifloxacin is a novel antibiotic belonging to the benzoquinolizine subclass of fluoroquinolones with potent activity against MRSA and quinolone-resistant Staphylococcus aureus. IV levonadifloxacin and its oral prodrug alalevonadifloxacin have recently been approved in India for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) including diabetic foot infections.
Objectives
To investigate the in vitro activity of levonadifloxacin against contemporary clinical isolates collected from multiple tertiary care hospitals across India in the Antimicrobial Susceptibility Profiling of Indian Resistotypes (ASPIRE) surveillance study.
Methods
A total of 1376 clinical isolates, consisting of staphylococci (n = 677), streptococci (n = 178), Enterobacterales (n = 320), Pseudomonas aeruginosa (n = 140) and Acinetobacter baumannii (n = 61), collected (2016–18) from 16 tertiary hospitals located across 12 states in India, were included in the study. The MICs of levonadifloxacin and comparator antibiotics were determined using the reference agar dilution method and broth microdilution method.
Results
Levonadifloxacin exhibited potent activity against MSSA (MIC50/90: 0.5/1 mg/L), MRSA (MIC50/90: 0.5/1 mg/L) and levofloxacin-resistant S. aureus (MIC50/90: 1/1 mg/L) isolates. Similarly, potent activity of levonadifloxacin was also observed against CoNS including MDR isolates (MIC50/90: 1/2 mg/L). Against Streptococcus pneumoniae, levonadifloxacin (MIC50/90: 0.5/0.5 mg/L) showed superior activity compared with levofloxacin (MIC50/90: 1/2 mg/L). Among levofloxacin-susceptible Enterobacterales, 80.6% of isolates were inhibited at ≤2 mg/L levonadifloxacin.
Conclusions
Levonadifloxacin displayed potent activity against contemporary MRSA and fluoroquinolone-resistant staphylococcal isolates, thus offering a valuable IV as well as an oral therapeutic option for the treatment of ABSSSIs. Furthermore, levonadifloxacin exhibited a broad-spectrum activity profile as evident from its activity against streptococci and levofloxacin-susceptible Gram-negative isolates.
Introduction: SARS-CoV2 which is a corona virus also predisposes patient to secondary bacterial infection by various mechanisms like- damaging the respiratory epithelium, profoundly affecting the innate and adaptive immunity, antagonising Interferon responses that enhance bacterial adherence, colonisation and invasion to respiratory tissue. In addition, prolonged hospital stay, invasive therapeutic devices, widespread use of empiric antibiotics and most importantly use of immune-suppressants like Steroid or Tocilizumab further increases the chances of bacterial infection. As opposed to this concept- physical distancing, frequent hand washing and use of gloves and protective gear by the healthcare workers also diminishes the chance of secondary bacterial infection. The present study is done to delineate the bacteriological profile, infection site predisposition or to gain knowledge on antibiotic sensitivity pattern.
Method : Retrospective data will be analyzed from June 2020, when the first COVID wave came to June 2021, corresponding to second COVID wave. The present study is a pilot study before collecting and analyzing the whole data Only those samples which were positive for bacterial isolates were randomly selected and the COVID status and drug resistance patterns were checked.
Results and discussion: The most common organism found was Klebsiella. Acinetobacter was also found in few patients. But most striking finding was that COVID positive patients showed higher incidence of antibiotic resistance with Acinetobacter. Though E Coli was also found commonly in COVID positive patients, they were not drug resistant.
Conclusion: MDR infections are common in COVID patients. Acinetobacter and Klebsiella are prone to develope MDR infections. While E.Coli is also common in COVID patients, chance of drug resistance is less among them.
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