Topic
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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TL;DR: Quinupristin/dalfopristin appears safe and efficacious in critically ill immunocompromised children with renal or hepatic impairment in paediatric liver transplant recipients.
Abstract: We describe our experience of quinupristin/dalfopristin for glycopeptide-resistant Enterococcus faecium (GREF) infections in 19 paediatric liver transplant recipients. The median patient age was 2 years and all were receiving immunosuppressive regimens. Quinupristin/ dalfopristin was well tolerated and complete resolution of infection was seen in 74% of patients. Side-effects included reversible elevation of serum alkaline phosphatase, skin rash, itching, diarrhoea and vomiting, but therapy was not withdrawn from any patient. Quinupristin/ dalfopristin appears safe and efficacious in critically ill immunocompromised children with renal or hepatic impairment.
19 citations
TL;DR: Data suggest that at least three different macrolide-resistance determinants are prevalent in Germany and that mefA has spread rapidly into multiple clones of S. pyogenes.
Abstract: Macrolide-resistance was assessed in 216 consecutive Streptococcus pyogenes isolates from throat infections in the region of Aachen, Germany. Seventeen isolates were resistant to erythromycin: 12 isolates revealed a macrolide (M) phenotype and harbored mefA, and five strains expressed an inducible macrolide-lincosamide-streptogramin B (MLSB) phenotype of which four strains harbored ermA(TR) and one strain contained ermB(AM). Telithromycin (HMR 3647) and quinupristin/dalfopristin remained active particularly against the ermA(TR)-containing S. pyogenes isolates studied. Random amplified polymorphic DNA analysis identified multiple clones among erythromycin-resistant strains, but did not discriminate beyond the emm-type. mefA was present in three isolates either with emm2, emm12, or emm75, and in nine isolates with emm4. All four strains with ermA(TR) contained emm77, and the single strain with ermB(AM) harbored emm1. Despite the relative low rate of macrolide-resistance, these data suggest that at least thr...
18 citations
TL;DR: No medical therapy is reliably effective for endocarditis caused by strains resistant to all cell wall-active antibiotics and all aminoglycosides, but new antimicrobial agents, such as linezolid and quinupristin/dalfopristin, have recently become available, but their activity against enterococci is mainly bacterostatic.
Abstract: Enterococcus was designated a genus distinct from the streptococci in 1984. Enterococci cause a variety of monomicrobial and polymicrobial infections, mainly in compromised patients. These infections include bacteremia, urinary and biliary tract infections, intra-abdominal sepsis, and decubitus and diabetic foot ulcers. Enterococcal infections may be acquired from the patient’s endogenous intestinal flora or exogenously from a fecally contaminated environment. Enterococci are inherently resistant to many antimicrobial agents and readily acquire additional resistances, which is likely the reason that enterococci have become prominent nosocomial pathogens. Only the combination of a cell wall-active antibiotic to which the Enterococcus is susceptible (ie, certain β-lactams or vancomycin) plus an aminoglycoside (ie, gentamicin or streptomycin) is bactericidal, and is required for cure of endocarditis, meningitis and probably infection in neutropenic patients; bacteriostatic activity is sufficient to treat most other infections. Treatment of infections caused by strains resistant to b-lactams, glycopeptides and aminoglycosides has become problematic due the limited number of therapeutic options. No medical therapy is reliably effective for endocarditis caused by strains resistant to all cell wall-active antibiotics and all aminoglycosides. New antimicrobial agents, such as linezolid and quinupristin/dalfopristin, have recently become available, but their activity against enterococci is mainly bacterostatic.
18 citations
TL;DR: The results obtained by determining cfu indicated that the combination of subinhibitory concentrations of quinupristin/dalfopristin plus vancomycin produced after 24 h, in vancomYcin-resistant strains, a consistent degree of synergy.
Abstract: Clinical specimens were cultured, and the strains identified by the Vitek system as Enterococcus faecium were characterized by their DNA. The MIC vancomycin, quinupristin/ dalfopristin and teicoplanin for each isolate was determined. Ten vancomycin-sensitive and ten vancomycin-resistant strains of E. faecium were tested. Quinupristin/dalfopristin at 0.25 x MIC and vancomycin at 0.5 x MIC separately as well as in combination were added to Trypticase Soy Broth tubes inoculated with a 24 h culture. The results obtained by determining cfu at 2, 4, 8, 12 and 24 h indicated that the combination of subinhibitory concentrations of quinupristin/dalfopristin plus vancomycin produced after 24 h, in vancomycin-resistant strains, a consistent degree of synergy. Synergy was observed up to only 12 h when similar combinations were employed for vancomycin-sensitive strains. Vancomycin-sensitive strains tended to be slightly less susceptible to quinupristin/ dalfopristin than vancomycin-resistant strains.
18 citations
TL;DR: The presence of common PhP types and also SCCmec type III, as an indicator for hospital strains, among the isolates, may indicate an epidemiological link between clinical and sewage MRSA isolates in Tehran.
Abstract: Background: Methicillin-resistant Staphylococcus aureus (MRSA) is known as a common pathogen in nosocomial and communityacquired infections. Sewage acts as an environmental reservoir and may have a significant role in development and dissemination of antibiotic resistance. Objectives: This study was undertaken to determine the epidemiological relatedness between the MRSA isolated from sewage and human infections. Materials and Methods: Samples were collected from a referral hospital and also a sewage treatment plant in Tehran, Iran, during 2010. All the MRSA isolates were identified at the species level and typed using Phene plate (PhP) system and SCC mec typing. Antibiotic susceptibility tests were also performed. Results: Of the 1142 isolates, 200 MRSA strains from the sewage (n = 100) and the clinic (n = 100) were isolated. Distinct PhP types, consisting of 16 common types and 13 single types, and also 3 different staphylococcal cassette chromosome mec (SCCmec) types (III, IVa and IVc) were found amongst the MRSA isolated from the two different sources. The results of antibiotic susceptibility testing showed an increased resistance to penicillin, ciprofloxacin, erythromycin, clindamycin and tetracycline. In addition, none of the isolates showed resistance to vancomycin, quinupristin -dalfopristin and linezolid. Conclusions: The presence of common PhP types and also SCCmec type III, as an indicator for hospital strains, among the isolates, may indicate an epidemiological link between clinical and sewage MRSA isolates in Tehran.
18 citations