In vitro antimicrobial susceptibility of glycopeptide-resistant enterococci

Freeman, Collin D.; Robinson, Alex Lockwood; Cooper, Brian; Mazens-Sullivan, Mary F.; Quintiliani, Richard; Nightingale, Charles H.

doi:10.1016/0732-8893(94)00113-b

Cited by 41 publications

(13 citation statements)

References 9 publications

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“…These results confirm that vanB expression confers inducible resistance to vancomycin but not to teicoplanin [2,20]. The resistance conferred by vanC expression is low against both drugs in general [21]. In addition, VRE with the vanC gene showed a synergistic response to the combination of vancomycin and teicoplanin (Fig.…”

Section: Resultssupporting

confidence: 84%

“…1c). Using our VRE detection and differentiation method, the VanA, VanB and VanC phenotypes can be differentiated after 24-48 h. vanC-mediated resistance to teicoplanin is low [21], although the bacteria grew slowly during 48 h incubation with teicoplanin. After 24 h incubation, almost no growth of vanC-expressing VRE was observed.…”

Section: Resultsmentioning

confidence: 99%

“…The resistance conferred by vanA expression is constitutive and high against both vancomycin and teicoplanin [21], while vanB expression results in inducible resistance to vancomycin but not to teicoplanin and thus, resistance to teicoplanin is relatively low [1,2,6,20], unless selected for the constitutive VanB phenotype. Therefore, vanA-VRE showed high resistance to both vancomycin and teicoplanin in this study (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Rapid detection and differentiation method of VanA, VanB and VanC phenotypes in vancomycin-resistant enterococci

Hanaki

Yamaguchi

Nomura

et al. 2004

International Journal of Antimicrobial Agents

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Section: Resultssupporting

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Rapid detection and differentiation method of VanA, VanB and VanC phenotypes in vancomycin-resistant enterococci

Hanaki

Yamaguchi

Nomura

et al. 2004

International Journal of Antimicrobial Agents

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“…Quinupristin/dalfopristin has a broad spectrum of activity in vitro against gram-positive bacteria, including coagulase-negative staphylococci, methicillinsusceptible and methicillin-resistant Staphylococcus aureus, and multidrug-resistant strains of Streptococcus pneumoniae. Quinupristin/dalfopristin is also active against most vancomycinresistant strains of Enterococcus faecium [24,25]. This activity of quinupristin/dalfopristin against vancomycin-resistant E. faecium is generally bacteriostatic and not bactericidal [25].…”

mentioning

confidence: 97%

Quinupristin/Dalfopristin Therapy for Infections Due to Vancomycin-Resistant Enterococcus faecium

Winston

Emmanouilides

Kroeber

et al. 2000

Clinical Infectious Diseases

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The efficacy and safety of quinupristin/dalfopristin for treatment of infections due to vancomycin-resistant Enterococcus faecium were evaluated in 24 hospitalized patients with documented infections (19 bacteremias, 5 localized infections) caused by vancomycin-resistant E. faecium that was susceptible to quinupristin/dalfopristin in vitro. Patients received iv quinupristin/dalfopristin at a dosage of either 7.5 mg/kg every 8 h or 5 mg/kg every 8 h. A favorable clinical response (cure or improvement) occurred in 19 (83%) of 23 evaluable patients; bacteriologic eradication occurred in 17 (74%) of 23 evaluable patients. A favorable clinical response was observed in 12 (80%) of 15 patients who were treated with 7.5 mg/kg of quinupristin/dalfopristin every 8 h and in 7 (88%) of 8 patients treated with 5 mg/kg of quinupristin/dalfopristin every 8 h. Two of four treatment failures were associated with a decrease in the in vitro susceptibility of vancomycin-resistant E. faecium to quinupristin/dalfopristin. Superinfections developed in 6 patients (26%), but only one was caused by Enterococcus faecalis that was resistant to quinupristin/dalfopristin. Myalgias and arthralgias were the only adverse events related to quinupristin/dalfopristin. These conditions occurred in 8 (33%) of 24 patients and were dose-related (8 cases in 16 patients treated with 7.5 mg/kg of quinupristin/dalfopristin every 8 h, no cases in 8 patients treated with 5 mg/kg every 8 h). Mortality associated with vancomycin-resistant E. faecium infection was 17% (4 of 23 patients), whereas mortality from other causes was 52% (12 of 23 patients). These results suggest that quinupristin/dalfopristin is effective as treatment for vancomycin-resistant E. faecium infections in critically ill patients with serious underlying conditions. Except for myalgias and arthralgias at higher dosages, the drug is well-tolerated.

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“…Quinupristin/dalfopristin (Synercid) is a new injectable streptogramin composed of two synergistic components (quinupristin and dalfopristin) with bactericidal activity against most gram-positive pathogens, and is more potent than erythromycin and ciprofloxacin against staphylococci [7][8][9]. The purpose of this study was to determine the in vitro activity, post-antibiotic effect (PAE) and bactericidal kinetics of quinupristin/dalfopristin against a number of gram-positive isolates.…”

Section: Introductionmentioning

confidence: 99%

In vitro Activity and Post-Antibiotic Effect of Quinupristin/Dalfopristin (Synercid)

Ling

Fung²,

Cheng³

2001

Chemotherapy

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The in vitro activities of quinupristin/dalfopristin (Synercid), ampicillin, erythromycin, clarithromycin, vancomycin, teicoplanin, ciprofloxacin and tetracycline were examined and compared against 526 gram-positive bacteria. The minimal inhibitory concentrations (MICs) for quinupristin/dalfopristin against Staphylococcus aureus, including methicillin-resistant strains, were low (MIC₉₀ = 0.5 mg/l), and were comparable with those of vancomycin and teicoplanin. This compound was superior to the macrolides and highly active against Streptococcus pneumoniae (both penicillin-sensitive and penicillin-resistant strains), with MIC₉₀ = 2 mg/l. It was also active against other streptococci, with MIC₉₀ = 4 mg/l. However, this agent is less active against enterococci (MIC₉₀ = 32 mg/l). Quinupristin/dalfopristin showed high activity against gram-positive anaerobes, including Clostridium spp., Peptococcus spp. and Peptostreptococcus spp., with MIC₉₀ ≤2 mg/l. Quinupristin/dalfopristin was also investigated for its post-antibiotic effect (PAE) and bactericidal kinetics against nine strains of gram-positive organisms, including staphylococci, enterococci and pneumococci. Exponentially growing (log phase) cultures were exposed to quinupristin/dalfopristin at 2 × MIC. Growth kinetics was evaluated using viable counting. The drug was uniformly bactericidal against pneumococci and staphylococci within 2 and 8 h of exposure, respectively. The killing activity against enterococci was weak; there was little or no reduction in bacterial count over 24 h of incubation. PAEs ranging from 2.13 to 3.28 h, 0.92 to 3.02 h and 1.89 to 7.07 h were produced on the tested pneumococci, staphylococci and enterococci, respectively. This study showed that quinupristin/dalfopristin is a promising agent active against gram-positive bacteria. The prolonged PAEs also suggest that the drug could be used intermittently at more widely spaced dosing intervals against gram-positive organisms.

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In vitro antimicrobial susceptibility of glycopeptide-resistant enterococci

Cited by 41 publications

References 9 publications

Rapid detection and differentiation method of VanA, VanB and VanC phenotypes in vancomycin-resistant enterococci

Rapid detection and differentiation method of VanA, VanB and VanC phenotypes in vancomycin-resistant enterococci

Quinupristin/Dalfopristin Therapy for Infections Due to Vancomycin-Resistant Enterococcus faecium

In vitro Activity and Post-Antibiotic Effect of Quinupristin/Dalfopristin (Synercid)

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