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Dalfopristin

About: Dalfopristin is a research topic. Over the lifetime, 696 publications have been published within this topic receiving 26621 citations. The topic is also known as: RP-54476 & Dalfopristina.


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Dissertation
09 Oct 2008
TL;DR: In this article, the authors investigated the relationship between intramammary treatment and the antimicrobial resistance of the bacteria from the intestinal tract and found that DCT increased significantly the ceftiofur resistance of E. coli and Enterococcus.
Abstract: The objective of the project was to detennine if the intramammary dry cow treatment (DCT) can increase the antimicrobial resistance of the intestinal bacteria Escherichia coli and Enterococcus spp. and also the mammary pathogens. The presence of the antibiotic from DCT in plasma was confirmed by tandem mass spectrometry. This presence is required to address the relationship between the intramammary treatment and the antimicrobial resistance of the bacteria from the intestinal tract. Milk and fecal samples were taken before dry-off and after calving to observe the antimicrobial resistance effect in E. coli and Enterococcus as well as mammary pathogens. These bacteria were isolated and identified as per protocols from the National Mastitis Council. These isolated bacteria were separated in two groups: dry treated cows and non-dry treated cows. Escherichia coli and Enterococcus spp. were submitted to the antimicrobial susceptibility microdilution protocol to determine the minimal inhibitory concentration (MIC) white bacterial isolates recovered from milk samples were examined with the disk diffusion test. Statistical analysis revealed that DCT increased significantly the ceftiofur resistance of the E. coli from the intestinal tract. However, the quinupristin / dalfopristin and the lincomycin resistances found in the enterococci isolates were decreased when cows were treated at dry-off. A non statistically significant increase in resistance was also observed in Staphylococcus aureus and Staphylococcus spp., recovered from milk, against penicillin / novobiocin and sulfisoxazole respectively in the dry treated group.

2 citations

Journal ArticleDOI
TL;DR: Although vancomycin and quinpristin-dalfopristin have been recommended as alternative treatments for MRSA, Staphylococci resistant to qin pristin–dalfopsolid have been reported.
Abstract: I have read the case report “Emergence of Pristinamycin resistance in India” by Keshari et al[1] The authors have reported two cases of neonatal septicemia, caused by Methicillin-resistant Staphylococcus aureus (MRSA), showing primary in vitro pristinamycin resistance. We would like to share our observations with the readership of the IJP. Methicillin resistant Staphylococcus aureus has become an important nosocomial pathogen. Glycopeptides have been the drugs of choice for treating MRSA infections. However, with the emergence of intermediate susceptibility to glycopeptides, other treatment alternatives, such as, quinpristin–dalfopristin and linezolid have become important. Quinpristin–dalfopristin is a combination of streptogramin B and A compounds with a synergistic activity against most gram-positive bacteria.[2] Quinpristin-dalfopristin is approved in the United States for treatment of infections caused by vancomycin-resistant strains of E. faecium and skin infections caused by MRSA and Streptococcus pyogenes. In Europe, it is also being used in the treatment of nosocomial pneumonia and other infections caused by MRSA. We have isolated a total of 63 Staphylococci from blood cultures in the last six months. The blood cultures were processed by the automated and computerized blood culture system (BACTEC BD). The blood culture medium used was trypticase soya broth. Positive blood samples were subcultured and their growth was identified by standard biochemical reactions. Antibiotic sensitivity was conducted with the help of the API-BioMerieux machine. This instrument used a computer-assisted analysis of growth in plastic cards to calculate the minimum inhibition concentration (MIC). The ATB STAPH strip was designed following the National Committee for Clinical Laboratory Standards (NCCLS) / Clinical and Laboratory Standards Institute (CLSI) recommendations.[3–5] Out of 38 Staphylococcus aureus isolated from the blood samples, 17 were MRSA. Three MRSA were found to be resistant to vancomycin (MIC > 16 mg/l), teicoplanin, and to quinpristin-dalfopristin (MIC > 2 mg/l). Out of the 17 MRSA, 14 showed sensitivity to vancomycin and quinpristin-dalfopristin. A total of 25 Coagulase negative staphylococci (CONS) were isolated from the blood samples. Out of nine methicillin-resistant CONS, four were detected to be vancomycin, teicoplanin, and quinpristin–dalfopristin resistant. All these seven vancomycin, quinpristin-dalfopristin-resistant staphylococci were isolated from the blood samples of neonates and pediatric patients. Out of these 63 isolates of staphylococci, 61 were found to be sensitive to minocycline. One interesting observation was that all the seven resistant isolates were sensitive to minocyclin [Table 1]. Table 1 Antibiotic resistance pattern of Staphylococci isolated from clinical samples Although vancomycin and quinpristine–dalfopristin have been recommended as alternative treatments for MRSA, Staphylococci resistant to qinpristin–dalfopristin have been reported. Deep et al. studied the drug resistance of Staphylococci in north India.[6] They isolated 54% MRSA and 64% quinpristin–dalfopristin resistant Staphylococcus aureus from pus and urine samples. Four quinpristin–dalfopristin resistant CONS were also reported. Our findings are similar to your report. Quinpristin–dalfopristin is not used routinely in our hospital for treatment. Infections by gram-positive cocci are becoming more difficult to treat, because of the rapid emergence of antibiotic resistance. Many MRSA and MRCONS are found to be sensitive to quinpristin–dalfopristin. We also agree that more comprehensive region-wise laboratory work is needed, before advocating this drug for multidrug–resistant, gram-positive infections.

2 citations

Journal ArticleDOI
TL;DR: In this article, a 61-year-old male who developed strongyloidiasis associated with vancomycin-resistant and linezolid-intermediate E. faecium meningitis after receiving corticosteroids was treated with high-dose daptomycin 12 mg/kg, line zolid, tigecycline and quinupristin/dalfopristin. Despite negative cultures, the patient expired.
Abstract: What is known and objective The rhabditid nematode Strongyloides stercoralis is the major causative agent of disseminated strongyloidiasis (DS). In rare cases, DS has caused enterococcal meningitis. If DS-associated vancomycin-resistant Enterococcus faecium (VRE) meningitis is suspected, combination antibiotic therapy should be considered. Case summary We present a case of a 61-year-old male who developed DS associated with vancomycin-resistant and linezolid-intermediate E. faecium meningitis after receiving corticosteroids. The VRE meningitis was treated with high-dose daptomycin 12 mg/kg, linezolid, tigecycline and quinupristin/dalfopristin. Despite negative cultures, the patient expired. What is new and conclusion In patients with DS-associated VRE meningitis, early use of combination therapy may be warranted to improve patient outcomes.

2 citations

Journal ArticleDOI
Guido Funke, R. Troxler1
TL;DR: Quinupristin/dalfopristin exhibited good activity against true corynebacteria, with all isolates being interpreted as susceptible except for a single Corynebacterium minutissimum strain.
Abstract: Quinupristin/dalfopristin, a combination of two semisynthetic derivatives of pristamycin, belongs to the streptogramin class of antimicrobial agents and was introduced to the market a few years ago. It was mainly developed for the treatment of infections caused by multiresistant gram-positive cocci such as vancomycin-resistant enterococci or glycopeptide intermediate susceptible Staphylococcus aureus strains. However, due to the emergence of difficult-totreat infections caused by gram-positive rods [1, 2], we decided to examine the in vitro activity of quinupristin/ dalfopristin in combination and as single agents against a broad range of 400 coryneform bacteria representing 23 taxa using a microdilution method. The results of that evaluation are reported here. The 400 strains tested in this study had been collected at our routine laboratory as well as sent to our reference laboratory over the last 10 years. All strains had been stored in 10% skim milk at −70°C and were subcultured twice on Columbia sheep blood agar plates (BD, Heidelberg, Germany) before being used in the experiments. The 96-well microtiter plates containing quinupristin/ dalfopristin as well as quinupristin and dalfopristin as single agents in lyophilized form were supplied by MerlinDiagnostika (Bornheim-Hersel, Germany). The methodology used to determine MICs using the microtiter plates and H-medium has been described in detail before [3, 4]. Briefly, 100 μl of a bacterial suspension was put into each well and 12 drug concentrations (range, 0.03–64 μg/ml) per drug were tested. Due to the often delayed growth of coryneform bacteria (e.g., lipophilic corynebacteria and Actinomyces spp.), the microtiter plates were incubated at 35°C in ambient air for 48 h. Strains ATCC 29213 (S. aureus) and ATCC 29212 (Enterococcus faecalis) served as controls, and the MIC value for quinupristin/dalfopristin was always within the accepted limits. Breakpoints for coryneform bacteria have not yet been defined by either EUCAST or CLSI (formerly NCCLS), but quinupristin/ dalfopristin breakpoints for gram-positive bacteria are available from the latter organization [5] with MICs ≤1 μg/ml indicating susceptibility, an MIC of 2 μg/ml indicating intermediate susceptibility, and MICs ≥4 μg/ml indicating resistance. Overall, 1,200 MICs were determined (Table 1). Quinupristin/dalfopristin exhibited good activity against true corynebacteria, with all isolates being interpreted as susceptible except for a single Corynebacterium minutissimum strain. In addition, quinupristin/dalfopristin showed good activity (i.e., all isolates interpreted as susceptible) against Rothia dentocariosa as well as representatives of the genera Actinomyces and Arcanobacterium. In contrast, the activity of quinupristin/dalfopristin against strains belonging to the genera Arthrobacter, Cellulomonas, and Microbacterium was significantly lower, with 14 of 75 strains being intermediately susceptible and ten of 75 strains being resistant. Of the 400 strains included in the present study, 15 (3.8%) could be called intermediately susceptible and ten (2.5%) resistant. The MICs of the quinupristin/dalfopristin combination were lower against every single strain tested than those of each individual compound alone, indicating an additive or synergistic effect of the two antimicrobial agents together. Neither of the single compounds had significantly better activity than the other against isolates belonging to any particular genus. To date, eight reports have been published on the activity of quinupristin/dalfopristin against coryneform bacteria, and together they included a total of 545 strains [6–13]. The present study, with 400 strains, is by far the largest on the activity of quinupristin/dalfopristin against clinically relevant coryneform bacteria. It also included 23 taxa, which contrasts with previous studies that included beG. Funke (*) Department of Medical Microbiology and Hygiene, Gärtner and Colleagues Laboratories, Elisabethenstrasse 11, 88212 Ravensburg, Germany e-mail: ldg.funke@t-online.de Tel.: +49-751-502230 Fax: +49-751-502385

2 citations

Journal Article
TL;DR: Quinupristin/dalfopristin was the most active agent tested against E. faecium strains and indicates that vancomycin-resistant enterococci are often concomitantly resistant to multiple antibiotics.
Abstract: BACKGROUND The recent emergence of glycopeptide-resistant enterococci limits the treatment of enterococcal infections. The aim of this study was to evaluate the in vitro activity of a new streptogramin, quinupristin/dalfopristin, against 30 clinical isolates of vancomycin-resistant enterococci and compared with those of other 15 antimicrobials. MATERIAL AND METHODS Enterococci were identified by using Rapid ID 32 Strep system. Genotyping of the isolates was performed by PCR. The MICs of quinupristin/dalfopristin were determined by the agar dilution technique recommended by the NCCLS. Susceptibilities to the rest of antibiotics tested (teicoplanin, ampicillin, penicillin, imipenem, doxycicline, chloramphenicol, gentamicin, streptomycin, rifampin, levofloxacin, fleroxacin, trovafloxacin, sparfloxacin, pefloxacin and clinafloxacin) were determined by using the E test. beta-lactamase production was examined with nitrocefin disks. RESULTS Quinupristin/dalfopristin has demonstrated excellent activity against Enterococcus faecium (MIC90' 2 micrograms/ml). Enterococcus faecalis was considerably less susceptible than E. faecium, at concentration of 4 micrograms/ml inhibited only 31% of tested strains. For doxycicline 77% of strains were susceptible. Only five isolates were susceptible to clinafloxacin; the other quinolones tested displayed poor activity. Resistance to chloramphenicol was detected in 47% of isolates. None of the isolates produced beta-lactamase. CONCLUSIONS This study indicates that vancomycin-resistant enterococci are often concomitantly resistant to multiple antibiotics. Quinupristin/dalfopristin was the most active agent tested against E. faecium strains. On the basis of these results quinupristin/dalfopristin could be a therapeutic option for the treatment of vancomycin-resistant E. faecium infections.

2 citations


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Performance
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No. of papers in the topic in previous years
YearPapers
20237
202217
20219
202010
201913
201811