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linezolid daptomycin VRE

Nicholas J Mercuro, Susan L Davis, Marcus J Zervos, Erica S Herc
The role of enterococci in infectious diseases has evolved from a gut and urinary commensal to a major pathogen of concern. Few options exist for resistant enterococci, and appropriate use of the available agents is crucial. Areas covered: Herein, the authors discuss antibiotics with clinically useful activity against Enterococcus faecalis and E. faecium. The article specifically discusses: antibiotics active against enterococci and their mechanism of resistance, pharmacokinetic and pharmacodynamic principles, in vitro combinations, and clinical studies which focus on urinary tract, intra-abdominal, central nervous system, and bloodstream infections due to enterococci...
June 7, 2018: Expert Opinion on Pharmacotherapy
Ali Jahansepas, Mohammad Ahangarzadeh Rezaee, Alka Hasani, Yaeghob Sharifi, Marjan Rahnamaye Farzami, Alireza Dolatyar, Mohammad Aghazadeh
This study was conducted to investigate the phenotypic and genotypic characteristics of vancomycin-resistant Enterococcus faecalis and Enterococcus faecium. Antibiotic resistance and virulence genes in the aforementioned resistant isolates were studied using the epsilometer (E)-test and polymerase chain reaction (PCR). These isolates were subjected to typing by pulsed-field gel electrophoresis (PFGE). Thirty vancomycin-resistant enterococci (VRE; 18.75%) were isolated from a total of 160 various clinical specimens cultured for any bacterial growth...
April 30, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Lars Christian Lund, Barbara Juliane Holzknecht, Ulrik Stenz Justesen
Vancomycin-resistant enterococci (VRE) are a growing healthcare concern, and since 2012 the incidence has increased eightfold in Denmark. Treatment options for infections with ampicillin-resistant VRE are sparse, and there are no Danish guidelines concerning this topic. For treatment of uncomplicated VRE urinary tract infections, ciprofloxacin or nitrofurantoin can be used. The mainstay of treatment of bacteraemia and other severe infections caused by VRE is linezolid or high-dose daptomycin. Combination treatment is recommended for complicated infections and/or prolonged therapy...
April 16, 2018: Ugeskrift for Laeger
Chih-Ning Cheng, Shu-Wen Lin, Chien-Chih Wu
Linezolid, an oxazolidinone antibiotic, does not required dose adjustment in patients with Child's class A and B liver cirrhosis. The dose adjustment data for Child's class C liver cirrhosis is inadequate. We reported a case of Child's class C liver cirrhosis, in which lactic acidosis, an adverse effect related to prolonged use, occurred only after two weeks of linezolid treatment. A 63-year old male had underlying diseases, such as end-stage renal disease (ESRD) and Child's class C liver cirrhosis, and was admitted for hepatic encephalopathy management and liver transplantation evaluation...
March 1, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Geetarani Purohit, Rajni Gaind, Reetika Dawar, P K Verma, K C Aggarwal, Raman Sardana, Monorama Deb
Introduction: Enterococci are part of the normal intestinal flora and have been recognized as important human pathogens. Vancomycin Resistant Enterococci (VRE) are global threat as this resistance is transmissible and also poses a challenge for infection control. Aim: This study was undertaken to study phenotypic and genotypic characteristics of VRE from clinically significant infections among hospitalized patients and their association with gut colonization. Materials and Methods: Clinically significant isolates of enterococci (n=250) were studied...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Jung-Jr Ye, Shian-Sen Shie, Chun-Wen Cheng, Jeng-How Yang, Po-Yen Huang, Ting-Shu Wu, Ming-Hsun Lee, Ching-Tai Huang
BACKGROUND: Vancomycin-resistant Enterococcus faecium (VRE-fm) bacteremia causes significant mortality in hospitalized patients. We sought to investigate clinical characteristics, treatment outcomes, and microbiological eradication associated with VRE-fm bacteremia. METHODS: A retrospective cohort study was conducted and included 210 adult patients admitted between January 1, 2011 and December 31, 2015. RESULTS: The mean Pitt bacteremia score was 4...
October 5, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Sun Young Cho, Hye Mee Kim, Doo Ryeon Chung, So Hyun Kim, Hee Jae Huh, Cheol-In Kang, Kyong Ran Peck, Nam Yong Lee, Jae-Hoon Song
OBJECTIVES: This study aimed to determine the prevalence of linezolid-resistant (LR) vancomycin-resistant enterococci and to investigate the mechanisms of linezolid resistance with clinical and microbiological characterisation. METHODS: All vancomycin-resistant Enterococcus faecium (VREF) isolated from blood and rectal swab cultures during 2012-2015 were tested for linezolid resistance. LR-VREF isolates were tested for antimicrobial susceptibility, glycopeptide resistance genes and virulence genes...
March 2018: Journal of Global Antimicrobial Resistance
Ian Brasg, Marion Elligsen, Derek MacFadden, Nick Daneman
BACKGROUND: Swab screening for vancomycin-resistant Enterococcus (VRE) is used to identify VRE carriers and thus prevent transmission of this organism. We tested whether screening results could have unintended benefits in predicting the vancomycin susceptibility of subsequent Enterococcus infections experienced by these patients. METHODS: We conducted a retrospective cohort study of all patients admitted to a large tertiary care hospital between 2010 and 2015 who underwent swab screening for VRE before experiencing an Enterococcus sterile-site infection...
August 15, 2017: CMAJ Open
Rajanshu Verma, Allison L Baroco
Enterococcus casseliflavus is a rare non-faecium, non-faecalis, vancomycin-resistant enterococcus (VRE) that is responsible for up to 2% of all enterococcal infections. Septicaemia with this bacterium is usually seen in older patients with multiple comorbidities who have had several previous hospitalisations. Septicaemia with E. casseliflavus portends a poorer prognosis, and treatment usually involves administration of antienterococcal beta-lactams or anti-VRE medications such as linezolid or daptomycin. We present such a case of a 75-year-old man who developed E...
May 12, 2017: BMJ Case Reports
Juwon Yim, Jordan R Smith, Michael J Rybak
Enterococcus species are the second most common cause of nosocomial infections in the United States and are particularly concerning in critically ill patients with preexisting comorbid conditions. Rising resistance to antimicrobials that were historically used as front-line agents for treatment of enterococcal infections, such as ampicillin, vancomycin, and aminoglycosides, further complicates the treatment of these infections. Of particular concern are Enterococcus faecium strains that are associated with the highest rate of vancomycin resistance...
May 2017: Pharmacotherapy
Erin S Honsa, Vaughn S Cooper, Mohammed N Mhaissen, Matthew Frank, Jessica Shaker, Amy Iverson, Jeffrey Rubnitz, Randall T Hayden, Richard E Lee, Charles O Rock, Elaine I Tuomanen, Joshua Wolf, Jason W Rosch
Serious bacterial infections in immunocompromised patients require highly effective antibacterial therapy for cure, and thus, this setting may reveal novel mechanisms by which bacteria circumvent antibiotics in the absence of immune pressure. Here, an infant with leukemia developed vancomycin-resistant Enterococcus faecium (VRE) bacteremia that persisted for 26 days despite appropriate antibiotic therapy. Sequencing of 22 consecutive VRE isolates identified the emergence of a single missense mutation (L152F) in relA, which constitutively activated the stringent response, resulting in elevated baseline levels of the alarmone guanosine tetraphosphate (ppGpp)...
January 3, 2017: MBio
E-M Klupp, A Both, C Belmar Campos, H Büttner, C König, M Christopeit, M Christner, M Aepfelbacher, H Rohde
Vancomycin-resistant enterococci (VRE) are of ever-increasing importance, most notably in high-risk patient populations. Therapy options are often limited for these isolates, and apart from tigecycline and daptomycin, oxazolidinone linezolid is frequently administered. The broad usage of linezolid, however, has driven the emergence of linezolid-resistant VRE strains (LR-VRE), further shortening therapeutic options. Second-generation oxazolidinone tedizolid has the advantage of being active against a specific subset of LR-VRE, i...
December 2016: European Journal of Clinical Microbiology & Infectious Diseases
Ming Zhao, Liang Liang, Liwei Ji, Di Chen, Yatong Zhang, Yuanchao Zhu, Khilna Patel
Daptomycin and linezolid are the most commonly used antibiotics for bloodstream infection caused by vancomycin-resistant enterococci (VRE-BSI). However, the best therapeutic agent to treat VRE-BSI remains to be established. In order to provide evidence for an optimal treatment decision, a systematic review and meta-analysis was performed comparing the efficacy and safety of daptomycin and linezolid for the treatment of VRE-BSI. After thorough searching of relevant studies from MEDLINE, EMBASE, Clinicaltrials...
September 2016: International Journal of Antimicrobial Agents
Y-C Chuang, H-Y Lin, P-Y Chen, C-Y Lin, J-T Wang, S-C Chang
Treatment options for vancomycin-resistant enterococci (VRE) bloodstream infection are limited. Studies comparing daptomycin or linezolid in treating VRE bloodstream infection have conflicting results and suggest daptomycin underdosing. The responses to different daptomycin doses have not been studied. We conducted a multicentre prospective cohort study to compare linezolid and daptomycin (≥6 mg/kg) for the treatment of VRE bloodstream infection. The primary outcome was 14-day mortality. We used multivariate logistic regression analysis for outcome analysis and a generalized additive model for dose-dependent response estimation...
October 2016: Clinical Microbiology and Infection
Nicholas S Britt, Emily M Potter
This study aimed to evaluate the clinical outcomes of vancomycin-resistant enterococcal bloodstream infections (VRE BSI) caused by Enterococcus gallinarum or Enterococcus casseliflavus . Variables associated with treatment failure were determined and treatment options were compared. This was a national retrospective study of hospitalised Veterans Affairs patients with non- faecium , non- faecalis VRE BSI. The primary outcome was treatment failure, defined as a composite of: (i) 30-day all-cause mortality; (ii) microbiological failure; and (iii) 30-day VRE BSI recurrence...
June 2016: Journal of Global Antimicrobial Resistance
Christina Forstner, Mathias W Pletz
Infections with multi-drug resistant bacteria are increasing worldwide. Glycopeptides, linezolid, daptomycin and 5th generation cephalosporins ("MRSA-cephalsoporins") are used against severe infections with MRSA, combination partners are rifampin and fosfomycin. Treatment options against VRE-infections are limited to linezolid, daptomycin and tigecyclin. New agents with activity against MRSA and VRE are tedizolid, dalbvancin and oritavancin. For monotherapy of severe infections due to 3MRGN carbapenems are available...
February 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Chunjiang Zhao, Hongbin Chen, Hui Wang, Wenen Liu, Chao Zhuo, Yunzhuo Chu, Ji Zeng, Yan Jin, Zhidong Hu, Rong Zhang, Bin Cao, Kang Liao, Bijie Hu, Xiuli Xu, Yanping Luo, Mingxiang Zou, Danhong Su, Yong Wang, Bin Tian, Hongwei Zhou, Yingmei Liu, Penghao Guo, Chunmei Zhou, Xiao Chen, Zhanwei Wang, Feifei Zhang
OBJECTIVE: To investigate the spectrum and antimicrobial resistance of major pathogensthat causing nosocomial infections in China, 2013. METHODS: Nosocomial cases as well as pathogens causing bloodstream infections (BSI), hospital-acquired pneumonia (HAP) and intra-abdominal infections (IAI) from 13 teaching hospital around China were collected. The minimum inhibitory concentrations (MICs) were determined by the agar dilution method. The CLSI M100-S23 criteria were used for interpretation...
June 9, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Jennifer A Johnson, Eoin R Feeney, David W Kubiak, G Ralph Corey
Oritavancin is a novel lipoglycopeptide with activity against Gram-positive organisms including streptococci, methicillin-resistant Staphylococcus aureus, vancomycin-resistant S aureus (VRSA), and vancomycin-resistant enterococci (VRE) [1-3]. The US Food and Drug Administration approved oritavancin as a single intravenous dose of 1200 mg for the treatment of acute bacterial skin and skin structure infections on the basis of 2 clinical trials demonstrating noninferiority compared with vancomycin [4, 5]. There are limited options for treatment of serious VRE infections...
December 2015: Open Forum Infectious Diseases
Katie E Barber, Jordan R Smith, Animesh Raut, Michael J Rybak
OBJECTIVES: Tedizolid displays potent activity against Gram-positive pathogens. In vitro studies against clinical isolates of Staphylococcus aureus and enterococci demonstrated improved tedizolid activity over linezolid. However, this is not well-characterized against a large collection of resistant isolates, including vancomycin-intermediate S. aureus (VISA), heterogeneous VISA (hVISA), daptomycin-non-susceptible (DNS) S. aureus, linezolid-resistant (LR) S. aureus and VRE. Therefore, our objective was to determine tedizolid activity versus other agents, against MRSA and VRE with various resistance phenotypes...
January 2016: Journal of Antimicrobial Chemotherapy
Chang-Ro Lee, Jung Hun Lee, Kwang Seung Park, Byeong Chul Jeong, Sang Hee Lee
The increase of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) poses a worldwide and serious health threat. Although new antibiotics, such as daptomycin and linezolid, have been developed for the treatment of infections of Gram-positive pathogens, the emergence of daptomycin-resistant and linezolid-resistant strains during therapy has now increased clinical treatment failures. In the past few years, studies using quantitative proteomic methods have provided a considerable progress in understanding antibiotic resistance mechanisms...
2015: Frontiers in Microbiology
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