Treatment of Vancomycin-Resistant Enterococcal Infections in the Immunocompromised Host: Quinupristin-Dalfopristin in Combination with Minocycline

Raad, Issam; Hachem, Ray; Hanna, Hend; Girgawy, Essam; Rolston, Kenneth V. I.; Whimbey, Estella; Husni, Rola; Bodey, Gerald P.

doi:10.1128/aac.45.11.3202-3204.2001

Cited by 42 publications

(24 citation statements)

References 16 publications

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“…Wilcox et al showed that vancomycin and linezolid failed to eradicate staphylococci and enterococci in catheter biofilm (46). Similar observations were noted in our study: in homogeneous suspensions, linezolid, Q-D, daptomycin, and minocycline, which have been shown to be active against VREF bacteremia (4,17,20,30), had MICs of Յ8.0 mg/ml against VREF-CRB. However, in biofilm, a 2-mg/ml concentration of these antibiotics failed to completely inhibit the growth of the VREF-CRB organisms.…”

Section: Discussionsupporting

confidence: 77%

Vancomycin-Resistant Enterococcus faecium : Catheter Colonization, esp Gene, and Decreased Susceptibility to Antibiotics in Biofilm

Raad

Hanna

Boktour

et al. 2005

Antimicrob Agents Chemother

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To evaluate the molecular characteristics and antibiotic susceptibility in biofilm of vancomycin-resistant Enterococcus faecium (VREF) organisms that had caused catheter-related VREF bacteremia (VREF-CRB), we compared 22 isolates causing bacteremia obtained from patients with VREF-CRB with 30 isolates from control patients with gastrointestinal colonization by VREF. Using pulsed-field gel electrophoresis, we identified 17 unique strains among the 22 VREF-CRB isolates and 23 strains among the gastrointestinal isolates. The esp gene was detected in 53% (9 of 17) of the VREF-CRB and 61% (14 of 23) of the control strains (P ‫؍‬ 0.6). VREF-CRB produced heavier biofilm colonization of silicone disks than did control organisms (P < 0.001). Daptomycin, minocycline, and quinupristin-dalfopristin were each independently more active than linezolid in reducing biofilm colonization by VREF-CRB (P < 0.01), with daptomycin being the most active, followed by minocycline. In conclusion, the esp gene in VREF is not associated with heavy biofilm colonization or catheterrelated bacteremia. In biofilm, daptomycin and minocycline were the most active antibiotics against VREF, and linezolid was the least active.

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Section: Discussionsupporting

confidence: 77%

Vancomycin-Resistant Enterococcus faecium : Catheter Colonization, esp Gene, and Decreased Susceptibility to Antibiotics in Biofilm

Raad

Hanna

Boktour

et al. 2005

Antimicrob Agents Chemother

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“…116 Comparable results were achieved in treating staphylococcal line-associated bacteremia with quinupristin/dalfopristin or vancomycin in a prospective randomized comparative study that included cancer patients. 121 The response rate in vancomycin-resistant E. faecium infections, mainly bacteremias, was 55%-68% in two studies that largely included leukemia patients, including those with HSCT and neutropenia, 122,123 in one of these studies quinupristin/dalfopristin was combined with minocycline. 123 Arthralgia or myalgia developed in 6-36% of patients.…”

Section: Resistant Gram-positive Pathogensmentioning

confidence: 99%

“…121 The response rate in vancomycin-resistant E. faecium infections, mainly bacteremias, was 55%-68% in two studies that largely included leukemia patients, including those with HSCT and neutropenia, 122,123 in one of these studies quinupristin/dalfopristin was combined with minocycline. 123 Arthralgia or myalgia developed in 6-36% of patients. 99,122 Quinupristin/dalfopristin should preferably be administered via central venous catheter.…”

Section: Resistant Gram-positive Pathogensmentioning

confidence: 99%

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Targeted therapy against multi-resistant bacteria in leukemic and hematopoietic stem cell transplant recipients: guidelines of the 4th European Conference on Infections in Leukemia (ECIL-4, 2011)

et al. 2013

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The detection of multi-resistant bacterial pathogens, particularly those to carbapenemases, in leukemic and stem cell transplant patients forces the use of old or non-conventional agents as the only remaining treatment options. These include colistin/polymyxin B, tigecycline, fosfomycin and various anti-gram-positive agents. Data on the use of these agents in leukemic patients are scanty, with only linezolid subjected to formal trials. The Expert Group of the 4 th European Conference on Infections in Leukemia has developed guidelines for their use in these patient populations. Targeted therapy should be based on (i) in vitro susceptibility data, (ii) knowledge of the best treatment option against the particular species or phenotype of bacteria, (iii) pharmacokinetic/pharmacodynamic data, and (iv) careful assessment of the risk-benefit balance. For infections due to resistant Gram-negative bacteria, these agents should be preferably used in combination with other agents that remain active in vitro, because of suboptimal efficacy (e.g., tigecycline) and the risk of emergent resistance (e.g., fosfomycin). The paucity of new antibacterial drugs in the near future should lead us to limit the use of these drugs to situations where no alternative exists. ABSTRACT © F e r r a t a S t o r t i F o u n d a t i o n 2 0 1 3organizing committee and experts were solicited to form the working group. The group reviewed the published English-language literature and prepared proposals on treatment options for infections due to resistant bacteria. Papers for review were sought using PubMed with the terms "linezolid", "daptomycin", "quinupristin/ dalfopristin", "colistin or polymyxin", "tigecycline", "fosfomycin", "telavancin", "ceftaroline" AND "stem cell transplantation or bone marrow transplant or leukemia or hematological malignancy or cancer". References cited in the articles identified were also considered. In respect of 'Duration of therapy', the main search terms used were "antibiotic therapy"; "stem cell transplantation or bone marrow transplantation or hematological malignancy or cancer"; "febrile neutropenia" and "duration therapy", "discontinuation antibiotics" and "microbiologically documented infection". Definitions of resistanceA bacterial isolate was considered non-susceptible if it was categorized resistant, intermediate or non-susceptible when using clinical breakpoints of the European Committee on Antimicrobial Susceptibility Testing (EUCAST), Clinical and Laboratory Standards Institute (CLSI) or the US Food and Drug Administration (FDA). Definitions of 'MDR' vary among authors and usually presume resistance to at least two antibiotics used in empiric therapy (3 rd 4 th -generation cephalosporins, carbapenems or piperacillin/tazobactam) or resistance to at least three of the following antibiotic classes: antipseudomonal penicillins, cephalosporins, carbapenems, aminoglycosides and fluoroquinolones. [11][12][13][14][15] According to the recent definition of the European Centre for Disease Prevention and Control...

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“…The fact that the frequency of VREF susceptibility to Q-D did not decrease with its clinical use could be related to its limited use at our hospital, possibly due to adverse events (14). In addition, Q-D is an antibiotic made of the synergistic combination of two streptogramins, 70% dalfopristin, or streptogramin A, and 30% quinupristin, or streptogramin B. Dalfopristin binds to the ribosomal 50S site, changing its conformation and increasing the ability of quinupristin to bind to the bacterial ribosome.…”

mentioning

confidence: 99%

Clinical-Use-Associated Decrease in Susceptibility of Vancomycin-Resistant Enterococcus faecium to Linezolid: a Comparison with Quinupristin-Dalfopristin

Raad¹,

Hanna²,

Hachem³

et al. 2004

Antimicrob Agents Chemother

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The susceptibility of 135 vancomycin-resistant Enterococcus faecium bacteremic isolates to linezolid and quinupristin-dalfopristin was determined. All were susceptible to linezolid, while 88% were susceptible to quinupristin-dalfopristin prior to the clinical use of the drugs at our hospital. More than 6 months after their clinical use, a decrease in susceptibility was noted for only linezolid at 83%. This was related in part to a single G2576U gene mutation in domain V of the 23S rRNA gene.

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Treatment of Vancomycin-Resistant Enterococcal Infections in the Immunocompromised Host: Quinupristin-Dalfopristin in Combination with Minocycline

Cited by 42 publications

References 16 publications

Vancomycin-Resistant Enterococcus faecium : Catheter Colonization, esp Gene, and Decreased Susceptibility to Antibiotics in Biofilm

Vancomycin-Resistant Enterococcus faecium : Catheter Colonization, esp Gene, and Decreased Susceptibility to Antibiotics in Biofilm

Targeted therapy against multi-resistant bacteria in leukemic and hematopoietic stem cell transplant recipients: guidelines of the 4th European Conference on Infections in Leukemia (ECIL-4, 2011)

Clinical-Use-Associated Decrease in Susceptibility of Vancomycin-Resistant Enterococcus faecium to Linezolid: a Comparison with Quinupristin-Dalfopristin

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