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  • Title: In vitro activity of quinupristin/dalfopristin and other antibiotics against ampicillin-resistant enterococcus faecium.
    Author: Wang FD, Liu IM, Liu CY.
    Journal: Zhonghua Yi Xue Za Zhi (Taipei); 2000 Feb; 63(2):119-23. PubMed ID: 10677922.
    Abstract:
    BACKGROUND: Enterococcus faecium constitutes approximately 10% of clinical isolates of enterococci and is noted for its antimicrobial resistance. In particular, E faecium is commonly resistant to ampicillin. The optimal treatment for severe infections caused by these multi-resistant organisms has yet to be determined. METHODS: Enterococci tested were isolated from blood, pleural fluid and cerebrospinal fluid. Ampicillin-resistant Enterococcus faecium (AREF) was identified using the API Rapid Strep Kit system. A total of 58 isolates of AREF were enrolled in this study. Ten different antibiotics were tested, including Synercid (quinupristin/dalfopristin), teicoplanin, vancomycin, ampicillin, trimethoprim/sulfamethoxazole (TMP/SMX), ciprofloxacin, gentamicin, chloramphenicol, rifampicin and tetracycline. The agar dilution method described by the National Committee for Clinical Laboratory Standards was used to determine the minimum inhibitory concentrations (MICs) of the antibiotics tested. RESULTS: Teicoplanin showed the best in vitro activity. Its MIC ranged from 0.25 to 2 micrograms/ml with an MIC90 of 1 microgram/ml. The MIC of vancomycin was 0.5-128 micrograms/ml with an MIC90 of 2 micrograms/ml. Three strains were vancomycin resistant, and they were the VanB phenotype. The MIC of quinupristin/dalfopristin was 0.5 to 8 micrograms/ml with an MIC90 of 2 micrograms/ml. Chloramphenicol and tetracycline showed moderate susceptibility. AREF showed high resistance to other antibiotics tested, including ciprofloxacin, gentamicin, TMP/SMX and rifampicin. High-level gentamicin resistance (MIC > 1,000 micrograms/ml) was found in 78% of AREF tested. CONCLUSIONS: Teicoplanin showed the best in vitro activity against AREF. Clinical studies are necessary to confirm the efficacy of quinupristin/dalfopristin in vivo.
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