The new quinolones and their combinations with other agents for therapy of severe infections

Desplaces, Nicole; Gutmann, Laurent; Carlet, Jean; Guibert, J.; Acar, J. F.

doi:10.1093/jac/17.suppl_a.25

Cited by 74 publications

(35 citation statements)

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“…Three activities are responsible for this modification: acetylation, nucleotidylation, and phosphorylation. Amikacin is considered by some to be the aminoglycoside of choice for severe nosocomial infections, especially when it is used in combination with P-lactams or fluoroquinolones (9). In gram-negative bacteria, only three enzymes capable of leading to resistance to this drug have been identified: aminoglycoside 6'-N-acetyltransferase type I [AAC(6')-I], 3'-O-phosphotransferase type VI [APH(3')-VI], and 4'-O-nucleotidyltransferase [ANT(4')].…”

mentioning

confidence: 99%

Characterization of Acinetobacter haemolyticus aac(6')-Ig gene encoding an aminoglycoside 6'-N-acetyltransferase which modifies amikacin

Lambert

Gerbaud

Galimand

et al. 1993

Antimicrob Agents Chemother

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The amikacin resistance gene acc(6')-Ig of Acinetobacter haemolyticus BM2685 encoding an aminoglycoside 6'-N-acetyltransferase was characterized. The gene was identified as a coding sequence of 438 bp corresponding to a protein with a calculated mass of 16,522 Da. Analysis of the deduced amino acid sequence suggested that it was the fourth member of a subfamily of aminoglycoside 6'-N-acetyltransferases. The resistance gene was not transferable either by conjugation to Escherichia coli or to Acinetobacter baumannii or by transformation into Acinetobacter calcoaceticus. Plasmid DNA from strain BM2685 did not hybridize with an intragenic aac(6')-Ig probe. These results suggest a chromosomal location for this gene. The gene was detected by DNA hybridization in all 20 strains of A. haemolyticus tested but not in 179 other Acinetobacter strains, including A. baumannii, A. lwoffii, A. junii, and A. johnsonii and genospecies 3, 6, 11, 13, 14, 15, 16, and 17, of which 162 were amikacin resistant. The probe did not hybridize in dot blot assays with DNAs purified from members of the families Enterobacteriaceae and Pseudomonadaceae that encode 6'-N-acetyltransferases. These data suggest that the aac(6')-Ig gene is species specific and may be used to identify A. haemolyticus.

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confidence: 99%

Characterization of Acinetobacter haemolyticus aac(6')-Ig gene encoding an aminoglycoside 6'-N-acetyltransferase which modifies amikacin

Lambert

Gerbaud

Galimand

et al. 1993

Antimicrob Agents Chemother

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“…The current study demonstrated that the MICs of the quinolones for 34 strains of P. pseudomallei were lower than commonly achievable concentrations in serum of the five agents tested (2,4). Ciprofloxacin was the most effective agent, with an MIC for 90% of the strains tested of 8 ,ug/ml.…”

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confidence: 57%

“…No strains were noted to be susceptible to the other four antimicrobial agents. On the basis of achievable levels in blood (2,4) and our susceptibility data, the fluoroquinolones would not be considered appropriate …”

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confidence: 99%

Activities of five new fluoroquinolones against Pseudomonas pseudomallei

Winton

Everett

Dolan

1988

Antimicrob Agents Chemother

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Thirty-four isolates of Pseudomonas pseudomallei were tested by a broth microdilution technique for susceptibility to amifloxacin, ciprofloxacin, enoxacin, norfloxacin, and ofloxacin. Ciprofloxacin was the most active agent tested, with an MIC for 90% of the strainis tested of 8 ,ug/Iml. These in vitro results suggest that the fluoroquinolones tested would not be optimal for therapy of melioidosis.The new quinolones have marked activity against aerobic gram-negative rods, including many strains of Pseudomonas aeruginosa (4). Because Pseudomonas pseudomallei, the causative agent of melioidosis, is an important pathogen in certain parts of the world, and the current therapeutic armamentarium is limited, it would be desirable to find an additional effective agent against this pathogen (3,5). In reviewing the literature we found little information on the activity of the newer quinolones against P. pseudomallei. Therefore, we tested the susceptibilities of 34 isolates of P. pseudomallei to five fluoroquinolones in order to determine their possible role in the therapy of melioidosis.Thirty-four isolates of P. pseudomallei were provided from material collected by Richard A. Finkelstein. The strains were obtained from environmental sources in Thailand and from U.S. Armed Forces patients in Vietnam. The strains had previously been identified and had been stored in a lyophilized state for several years. All strains were reconstituted from the lyophilized state and harvested. They were frozen until needed and then grown in Mueller-Hinton broth, and an overnight growth of log-phase bacteria was used for inoculation. Escherichia coli ATCC 25922 and P. aeruginosa ATCC 27853 were used as control strains.Antimicrobial The results of the broth dilution susceptibility tests are shown in Table 1. Ciprofloxacin was the most active quinolone tested against all strains of P. pseudomallei. Current recommendations provided by the manufacturers suggest a cutoff value of 1 ,ug/ml for gram-negative rods to be considered susceptible to amifloxacin, ciprofloxacin, and ofloxacin and a cutoff value of 2 ,ug/ml for enoxacin and norfloxacin. As noted, all MICs for 90% of the strains tested exceeded these limits.The quinolones are potent antimicrobial agents for many pathogens. They provide an attractive oral therapeutic alternative to intravenous therapy in many situations. Because of their potency, ease of administration, low development of in vitro resistance, and low toxicity, they would be an appealing alternative to standard therapy in melioidosis.The current study demonstrated that the MICs of the quinolones for 34 strains of P. pseudomallei were lower than commonly achievable concentrations in serum of the five agents tested (2, 4). Ciprofloxacin was the most effective agent, with an MIC for 90% of the strains tested of 8 ,ug/ml. The results of our work are in agreement with those of Chau et al.(1). They tested the susceptibilities of 27 isolates of P. pseuidomallei to a number of antimicrobial agents, including two quinolones, ciproflox...

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“…In an open study, Ramirez [27] treated and cured three cases of arthritis due to N. gonorrhoeae and S. pneumoniae with ciprofloxacin. Remarkable results were obtained by Desplaces et al [28] with a combination of pefloxacin (400 mg twice daily) plus rifampin in patients with chronic osteomyelitis due to S. aureus. Fourteen of 14 patients were cured, with a follow-up of Waldvogel 9-24 months, results that confirm the experimental data described previously.…”

Section: Clinical Studiesmentioning

confidence: 90%

Use of Quinolones for the Treatment of Osteomyelitis and Septic Arthritis

Waldvogel¹

1989

Clinical Infectious Diseases

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The new quinolones and their combinations with other agents for therapy of severe infections

Cited by 74 publications

References 0 publications

Characterization of Acinetobacter haemolyticus aac(6')-Ig gene encoding an aminoglycoside 6'-N-acetyltransferase which modifies amikacin

Characterization of Acinetobacter haemolyticus aac(6')-Ig gene encoding an aminoglycoside 6'-N-acetyltransferase which modifies amikacin

Activities of five new fluoroquinolones against Pseudomonas pseudomallei

Use of Quinolones for the Treatment of Osteomyelitis and Septic Arthritis

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