Antimicrobial susceptibility of quinupristin/dalfopristin tested against gram-positive cocci from Latin America: results from the Global SMART (GSMART) surveillance study



Título del documento: Antimicrobial susceptibility of quinupristin/dalfopristin tested against gram-positive cocci from Latin America: results from the Global SMART (GSMART) surveillance study
Revista: The brazilian journal of infectious diseases
Base de datos: PERIÓDICA
Número de sistema: 000290668
ISSN: 1413-8670
Autores: 1
2
3

Instituciones: 1Universidade Federal de Sao Paulo, Divisao de Doencas Infecciosas, Sao Paulo. Brasil
2University of Iowa, College of Medicine, Iowa City, Iowa. Estados Unidos de América
3Millard Fillmore Hospital , Clinical Pharmacokinetics Laboratory, Buffalo, Nueva York. Estados Unidos de América
Año:
Periodo: Feb
Volumen: 5
Número: 1
Paginación: 21-31
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental
Resumen en inglés Gram-positive cocci are important causes of both nosocomial and community-acquired infections, and antimicrobial resistance among these pathogens has become an important problem worldwide. Since resistance among these organisms can vary substantially by geographic location, we conducted a multicenter surveillance study with isolates from five Latin American countries (15 medical centers). Quinupristin/dalfopristin (formerly RP-59500) is a novel streptogramin combination with focused activity against Gram-positive cocci, many exhibiting emerging resistance. The in vitro activity of quinupristin/dalfopristin and 12 other antimicrobial agents were evaluated against 1,948 strains including Staphylococcus aureus (747 strains), coagulase-negative staphylococci (CoNS; 446 strains), enterococci (429 strains), and various Streptococcus spp. (326 strains). Oxacillin resistance was observed in 41% of S. aureus (MIC, £ 2 mg/ml or ³ 13 mm) and 40% of CoNS (MIC, £ 0.25 mg/ml or ³ 18 mm). Vancomycin, teicoplanin, and quinupristin/dalfopristin (MIC90, 0.25 - 1 mg/ml) remained effective against all strains, but cross-resistance was high among other tested drugs. The quinupristin/dalfopristin MIC50 for Streptococcus pneumoniae and other streptococci was only 0.5 mg/ml (13% to 28% were penicillin-resistant; 12% to 22% were macrolide-resistant). Enterococci demonstrated variable inhibition by quinupristin/dalfopristin depending upon identification and the susceptibility testing method used. The demonstrated quinupristin/dalfopristin activity against Enterococcus faecium was confirmed, but potential species identification errors with various commercial systems continue to confuse susceptibility statistics, even though some strains of E. faecium confirmed by PCR-based or other molecular identification techniques did have quinupristin/dalfopristin MICs of ³ 4 mg/mL. Most important, glycopeptide-resistant enterococci are rapidly emerging in Latin America, and .....
Disciplinas: Medicina
Palabras clave: Farmacología,
Hospitales,
Microbiología,
Salud pública,
Resistencia antimicrobiana,
Quinupristina-dalfopristina,
Cocos Gram positivos,
Vigilancia
Keyword: Medicine,
Hospitals,
Microbiology,
Pharmacology,
Public health,
Antimicrobial resistance,
Quinupristin-dalfopristin,
Gram positive cocci,
Surveillance
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