In vitro activity of quinupristin/dalfopristin against selected bacterial pathogens isolated in Italy

Isolation of quinupristin/dalfopristin-resistant Streptococcus agalactiae from asymptomatic Korean women

Seven Streptococcus agalactiae isolates were obtained from the vagina of 80 asymptomatic women. Three of these isolates showed multi-drug resistant (MDR) phenotypes: two isolates were resistant to clarithromycin, clindamycin, erythromycin, and tetracycline; and one isolate was resistant to clarithromycin, clindamycin, erythromycin, tetracycline, and quinupristin/dalfopristin. There was no clonal relationship among the MDR isolates. This is the first report of quinupristin/dalfopristin-resistant S. agalactiae.

Activities of a new oral streptogramin, XRP 2868, compared to those of other agents against Streptococcus pneumoniae and haemophilus species

MIC methodology was used to test the antibacterial activity of XRP 2868, a new oral combination of two semisynthetic streptogramins, RPR 132552A and RPR 202868, compared to activities of other antibacterial agents against pneumococci, Haemophilus influenzae, and Haemophilus parainfluenzae. For 261 pneumococci, XRP 2868 and pristinamycin MICs were similar, irrespective of penicillin G and erythromycin A susceptibilities (MIC at which 50% of isolates were inhibited [MIC(50)], 0.25 micro g/ml; MIC(90), 0.5 micro g/ml), while quinupristin/dalfopristin had MICs which were 1 to 2 dilutions higher. Single components of both XRP 2868 and quinupristin/dalfopristin had higher MICs. Erythromycin A, azithromycin, clarithromycin, and clindamycin MICs were higher for penicillin G-intermediate and -resistant than -susceptible pneumococci. Against 150 H. influenzae strains, all compounds tested had unimodal MIC distributions. XRP 2868 had an overall MIC(50) of 0.25 micro g/ml and an MIC(90) of 1.0 micro g/ml, with no differences between beta-lactamase-positive, beta-lactamase-negative, and beta-lactamase-negative ampicillin-resistant strains. Of note was the similarly low activity of one of its components, RPR 132552A. Pristinamycin and quinupristin/dalfopristin had MICs of 0.125 to 8.0 micro g/ml; quinupristin alone had MICs of 8.0 to >64.0 micro g/ml, and dalfopristin had MICs of 1.0 to >64.0 micro g/ml. Erythromycin A, azithromycin, and clarithromycin had modal MICs of 4.0, 1.0, and 8.0 micro g/ml, respectively. MICs of all compounds against H. parainfluenzae were 1 to 2 dilutions higher than against H. influenzae. XRP 2868 showed potent activity against pneumococci and Haemophilus strains irrespective of their susceptibility to other agents.

Antibiotic susceptibility patterns and serotypes of antibiotic resistant and/or invasive Streptococcus pneumoniae strains circulating in Italy

Antibiotic susceptibility patterns and serotypes of 397 Streptococcus pneumoniae recovered from 1994 to 1998 in Italy have been determined. This collection included 229 penicillin- and/or erythromycin-resistant strains and 168 isolates responsible for invasive infections. Among penicillin-resistant pneumococci, the most prevalent serotype was 23F, followed by 19F and 9V, while among erythromycin-resistant but penicillin-susceptible strains serotype 6B was predominant followed by 19A, 14, 19F, 15A, 15B, and 23F. The most common invasive serotypes were 6B, 19F, 23F, 3, 4, 14, 20, 15B, and 9N. The currently available 23-valent pneumococcal vaccine could cover 91% of noninvasive penicillin- and/or erythromycin-resistant strains, 84% of pneumococci isolated from sterile sites, and 83% of invasive antibiotic-resistant S. pneumoniae. Penicillin-resistant pneumococci also showed reduced susceptibility to other antimicrobial compounds. Against invasive pneumococci, amoxicillin, cefotaxime, ceftriaxone, imipenem, vancomycin, and rifampin were 100% effective. Penicillin, chloramphenicol, erythromycin, tetracycline, and co-trimoxazole resistance was 1.8%, 9.5%, 15.5%, 18.5%, and 21.4%, respectively.

Comparative in vitro activities of linezolid, quinupristin-dalfopristin, moxifloxacin, and trovafloxacin against erythromycin-susceptible and -resistant streptococci

The in vitro activities of the new agents linezolid, quinupristin-dalfopristin, moxifloxacin, and trovafloxacin were determined and compared with those of penicillin, clindamycin, and four macrolides against 53 erythromycin-resistant Streptococcus pneumoniae, 117 S. pyogenes (64 erythromycin-susceptible and 53 -resistant), and 101 S. agalactiae (53 erythromycin-susceptible and 48 -resistant) isolates. Differentiation of macrolide resistance phenotypes was performed by the double-disk method. The genetic basis for macrolide resistance in 52 strains was also determined. The M phenotype was found in 84.9, 6.3, and 1.9% of S. pyogenes, S. agalactiae, and S. pneumoniae isolates, respectively. These strains were susceptible to miocamycin and clindamycin. Strains with the inducible phenotype accounted for 27.1% of S. agalactiae isolates and 9.4% each of S. pyogenes and S. pneumoniae isolates. All erythromycin-resistant isolates were also resistant to the 14- and 15-membered macrolides tested. Strains with all three phenotypes were susceptible to </=2 microgram of linezolid per ml. Quinupristin-dalfopristin exhibited good in vitro activity against all strains, irrespective of their resistance to erythromycin (MICs at which 90% of the isolates tested were inhibited [MIC(90)s], 0.2 to 1 microgram/ml). Against the erythromycin-resistant S. pyogenes and S. agalactiae strains, moxifloxacin and trovafloxacin were the most active agents (MIC(90)s, 0.1 microgram/ml). The new antimicrobials evaluated may be alternative agents to treat infections caused by macrolide-resistant as well as macrolide-susceptible streptococci.