The in vitro activities of LY-303366, a new semisynthetic echinocandin, and comparators amphotericin B, 5-fluorocytosine, fluconazole, and ketoconazole against 205 systemic isolates of Candida species, Cryptococcus neoformans, Blastomyces dermatitidis, and Aspergillus species were determined. LY-303366 had MICs of < or = 0.32 microg/ml for all Candida albicans (n = 99), Candida glabrata (n = 18), and Candida tropicalis (n = 10) isolates tested. LY-303366 was also active against Aspergillus species (minimum effective concentration at which 90% of the isolates are inhibited, 0.02 microg/ml) (n = 20), was less active against Candida parapsilosis (MIC at which 90% of the isolates are inhibited [MIC90], 5.12 microg/ml) (n = 10), and was inactive against C. neoformans (MIC90, >10.24 microg/ml) (n = 15) and B. dermatitidis (MIC90, 16 microg/ml) (n = 29).
Background: Acinetobacter spp. are a frequent cause of nosocomial as well as community-acquired infections and represent increasingly difficult therapeutic challenges. The Tigecycline Evaluation Surveillance Trial (TEST) is monitoring global resistance patterns of significant pathogens, including multidrug resistant (MDR) Acinetobacter spp. Methods: Clinically significant Acinetobacter spp. were obtained from sites in 9 countries (China, Hong Kong, India, Indonesia, Malaysia, Singapore, S. Korea, Taiwan and Thailand). MICs for piperacillin/tazobactam (PT), levofloxacin (LVX), ceftriaxone (CAX), cefepime (CPE), amikacin (AK), minocycline (MIN), ceftazidime (CAZ), tigecycline (TIG) and imipenem (IMI, 2004-06 only) and meropenem (MER, 2006-11 only) were determined using supplied broth microdilution panels and interpreted according to CLSI and FDA guidelines. Multidrug resistance was defined as resistance to 3 or more drug families. 619 of 978 (63.3%) Acinetobacter spp. collected were determined to be MDR. Results: The % MDR, MIC90 (μg/mL), and % susceptible (S) of Acinetobacter spp. from Asia, 2004-2011, are shown in the following table:Tabled 1Year20042005200620072008200920102011N MOR2419791711025411555MIC90%SMIC90%SMIC90%SMIC90%SMIC90%SMIC90%SMIC90%SMIC90%SAK>6416.7>6415.8>6412.7>6412.9>6413.7>6411.1>6419.1>6410.9CPE>320>320>326.3>322.9>321.0>321.9>320>321.8CAZ>320>320>321.3>322.3>325.9>325.6>322.6>321.8CAX>640>640>641.3>640.6>640>640>640>640IMI>1616.7>1652.6>1612.1ntntntntntntntntntntLVX>820.8>810.5>813.9>86.4>82.9>80>82.6>83.6MERntntnt94.7878.5878.41657.01657.4859.1852.7MIN888.0494.7878.5878.41657.01657.4859.1852.7PT>1284>1280>1286.3>1284.1>1280>1283.7>1280.9>1280TIG1na1na2na2na2na2na2na2na Open table in a new tab nt- not tested; na- no breakpoint available. Conclusion: TIG exhibited the lowest MIC90 (1-2μg/mL) across all years against MDR Acinetobacter, followed by minocycline (4-16μg/mL). The percentage of MDR isolates increased significantly over the eight years of the study (p<0.0001, Cochran-Armitage trend test). This increase in resistance emphasizes the need for continual active surveillance of antibiotic efficacy in Asia.
ObjectivesThe purpose of this study was to analyse Canadian national surveillance data, specifically fluoroquinolone resistance, from 2007 to 2011 inclusive, to determine trends in resistance over time and to assess correlations with patient demographic factors.
To compare the demographics, antimicrobial susceptibilities and molecular epidemiology of community-associated (CA) and healthcare-associated (HA) methicillin-resistant Staphylococcus aureus (MRSA) in Canada.Between 2007 and 2011, 1266 MRSA were collected from inpatients and outpatients attending tertiary-care medical centres across Canada. Susceptibility testing was performed using broth microdilution and isolates were characterized by spa typing and PCR to detect the Panton-Valentine leucocidin (PVL) gene. Detection of heterogeneous vancomycin-intermediate S. aureus (hVISA) was performed using the Etest macromethod and confirmed by population analysis profiling.The annual proportion of S. aureus that were methicillin resistant decreased from 26.1% in 2007 to 19.3% in 2011 (P= 0.0002). Of 1266 MRSA isolated, 366 (28.9%) were CA-MRSA genotypes and 868 (68.6%) were HA-MRSA genotypes. The proportion of MRSA represented by CA-MRSA genotypes increased from 19.7% to 36.4% between 2007 and 2011 (P < 0.0001). CMRSA10 (USA300) was the predominant CA-MRSA genotype (22.1%); the most common HA-MRSA genotype was CMRSA2 (USA100/800) (58.1%). PVL was detected in 328/366 (89.6%) of CA-MRSA genotypes and 6/868 (0.7%) of HA-MRSA genotypes. The hVISA phenotype was detected in 7/27 (25.9%) of MRSA with a vancomycin MIC of 2 mg/L.The most frequent CA-MRSA genotype was CMRSA10 (USA300), while CMRSA2 (USA100/800) was the predominant HA-MRSA genotype. Despite a decrease in the numbers of MRSA, the proportion of CMRSA10 (USA300) CA-MRSA has risen significantly between 2007 and 2011 in Canada.
We evaluated the benefits of prolonging norfloxacin therapy from 12 to 24 weeks for complicated urinary tract infection in a double-blind, randomized, placebo-controlled study. During the second 12 weeks, norfloxacin was superior to placebo (P less than 0.05) in suppressing bacteriuria. Adverse effects were common but mostly confined to the initial 12 weeks.
ABSTRACT The in vitro activity of ceftolozane in combination with tazobactam (fixed concentration of 4 μg/ml) was evaluated against 2,435 Pseudomonas aeruginosa clinical isolates obtained from across Canada using Clinical and Laboratory Standards Institute broth microdilution methods. The MIC 50 and MIC 90 values for ceftolozane-tazobactam were 0.5 μg/ml and 1 μg/ml, respectively (a 32-fold-lower MIC 90 than that for ceftazidime). Eighty-nine percent (141/158) of multidrug-resistant isolates were inhibited by ≤8 μg/ml of ceftolozane-tazobactam.
Background: Tigecycline (TIG) has potent expanded broad spectrum activity against most commonly encountered species responsible for community and hospital acquired infections. The T.E.S.T. program determined the in vitro activity of TIG against Acinetobacter resistant to one or more of piperacillin-tazobactam (PT), levofloxacin (LVX), ceftriaxone (CAX), cefepime (CPE), amikacin (AK), minocycline (MIN), ceftazidime (CAZ), and imipenem (IMP). Study strains were collected from hospitals in the United States from 2004–2007. Methods: A total of 2,367 clinical isolates were identified to species level from participating sites and confirmed by the central laboratory. Minimum Inhibitory Concentrations (MICs) were determined by the local laboratory using supplied broth microdilution panels and interpreted according to CLSI guidelines Results: Resistance rates for comparator drugs were CAZ 42%, CAX 41%, LVX 41%, CPE 34%, PT 17%, AK 7%, MIN 7%, and IMP 2%. TIG inhibited 98% of all isolates at = 8 mcg/ml. TIG MIC50/90 for strains resistant to 0, 1, 2, 3, 4, or ≥5 drug classes were 0.12/0.5, 0.5/1, 0.5/2, 1/2, 1/2, and 1/4, respectively, demonstrating a gradual diminishment of TIG activity in strains resistant to multiple drug classes Conclusions: TIG had good in vitro activity against most Acinetobacter strains resistant to one or more other drugs in this study, although the higher TIG MICs seen for these strains suggests some linkage to resistance mechanisms for other drugs (efflux). TIG remained effective in inhibiting multi-drug resistant Acinetobacter spp., further demonstrating its wide spectrum of activity vs. drug-resistant bacteria.
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