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Antimicrobial susceptibility of quinupristin/dalfopristin tested against gram-positive cocci from Latin America: results from the global SMART (GSMART) surveillance study.
Braz J Infect Dis. 2001 Feb; 5(1):21-31.BJ

Abstract

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, <e; 2 microg/ml or >e; 13 mm) and 40% of CoNS (MIC, <e; 0.25 microg/ml or >e; 18 mm). Vancomycin, teicoplanin, and quinupristin/dalfopristin (MIC(90), 0.25 - 1 mg/ml) remained effective against all strains, but cross-resistance was high among other tested drugs. The quinupristin/dalfopristin MIC(50) 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 >e; 4 microg/ml. Most important, glycopeptide-resistant enterococci are rapidly emerging in Latin America, and quinupristin/dalfopristin appears active against many of these isolates as well as having potency against nearly all staphylococci and streptococci tested at <e; 2 microg/ml or having a zone diameter of >e; 16 mm. Comparisons to GSMART results from other continents show nearly identical quinupristin/dalfopristin activity for each Gram-positive species tested. These results define the role of quinupristin/dalfopristin in Latin American medical centers and provide a benchmark for future in vitro comparisons.

Authors+Show Affiliations

Division of Infectious Diseases, Federal University of São Paulo, Rua Botucatu, 740, São Paulo/SP, 04023-063 Brazil. heliosader@uol.com.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11290311

Citation

Sader, H S., et al. "Antimicrobial Susceptibility of Quinupristin/dalfopristin Tested Against Gram-positive Cocci From Latin America: Results From the Global SMART (GSMART) Surveillance Study." The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases, vol. 5, no. 1, 2001, pp. 21-31.
Sader HS, Jones RN, Ballow CH, et al. Antimicrobial susceptibility of quinupristin/dalfopristin tested against gram-positive cocci from Latin America: results from the global SMART (GSMART) surveillance study. Braz J Infect Dis. 2001;5(1):21-31.
Sader, H. S., Jones, R. N., Ballow, C. H., Biedenbach, D. J., & Cered, R. F. (2001). Antimicrobial susceptibility of quinupristin/dalfopristin tested against gram-positive cocci from Latin America: results from the global SMART (GSMART) surveillance study. The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases, 5(1), 21-31.
Sader HS, et al. Antimicrobial Susceptibility of Quinupristin/dalfopristin Tested Against Gram-positive Cocci From Latin America: Results From the Global SMART (GSMART) Surveillance Study. Braz J Infect Dis. 2001;5(1):21-31. PubMed PMID: 11290311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial susceptibility of quinupristin/dalfopristin tested against gram-positive cocci from Latin America: results from the global SMART (GSMART) surveillance study. AU - Sader,H S, AU - Jones,R N, AU - Ballow,C H, AU - Biedenbach,D J, AU - Cered,R F, AU - ,, PY - 2001/4/6/pubmed PY - 2001/7/6/medline PY - 2001/4/6/entrez SP - 21 EP - 31 JF - The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases JO - Braz J Infect Dis VL - 5 IS - 1 N2 - 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, <e; 2 microg/ml or >e; 13 mm) and 40% of CoNS (MIC, <e; 0.25 microg/ml or >e; 18 mm). Vancomycin, teicoplanin, and quinupristin/dalfopristin (MIC(90), 0.25 - 1 mg/ml) remained effective against all strains, but cross-resistance was high among other tested drugs. The quinupristin/dalfopristin MIC(50) 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 >e; 4 microg/ml. Most important, glycopeptide-resistant enterococci are rapidly emerging in Latin America, and quinupristin/dalfopristin appears active against many of these isolates as well as having potency against nearly all staphylococci and streptococci tested at <e; 2 microg/ml or having a zone diameter of >e; 16 mm. Comparisons to GSMART results from other continents show nearly identical quinupristin/dalfopristin activity for each Gram-positive species tested. These results define the role of quinupristin/dalfopristin in Latin American medical centers and provide a benchmark for future in vitro comparisons. SN - 1413-8670 UR - https://www.unboundmedicine.com/medline/citation/11290311/Antimicrobial_susceptibility_of_quinupristin/dalfopristin_tested_against_gram_positive_cocci_from_Latin_America:_results_from_the_global_SMART__GSMART__surveillance_study_ L2 - https://core.ac.uk/reader/37704457?utm_source=linkout DB - PRIME DP - Unbound Medicine ER -