|
 |
 Home > Available Issues |
|
|
 Original Articles |
| In Vitro Antimicrobial Susceptibility of 10-Antimicrobial Agents Including Quinupristin/dalfopristin(Synercid®) against Vancomycin-resistant Enterococci Isolates from Clinical Specimens |
| Hee-Jin Cheong, Ki Ho Park, Dong Lim Kin, Woo Joo Kim, Min Ja Kim, Seung Chull Park, and Jong Hee Shin1 |
| Department of Internal Medicine, Korea University College of Medicine,1Department of Clinical Microbiology, Chonnam University College of Medicine, Seoul, Korea |
Vol.17 Num.2 (p137~144)
|
|
|
Background : Vancomcyin-resistant enterococci (VRE) have become a major nosocomial pathogen in the USA during 1990s. In Korea, VRE have recently emerged as a important nosocomial pathogen and posed therapeutic difficulty. We evaluated the antimicrobial susceptibility of clinical VRE isolates to the antimicrobial agents that are commonly used to treat enterococcal infections and to some alternative drugs and to a newer antibiotic such as quinupristin/dalfopristin(Synercid ®).
Methods : We evaluated 16 clinical VR-E. faecium (5 vanB VRE, 11 vanA VRE) strains that were isolated from Korea Universtiy and Chonnam University hospital during the last five years (1994-1998). The isolates were identified to the species level by using API 20system. The in vitro susceptibility testing was performed by the agar dilution methods, following the criteria described by the National Committee for Clinical Laboratory Standards (NCCLS). The VRE isolates were tested against antimicrobial agents commonly used to treat enterococcal infections (vancomycin, teicoplanin, ampicillin, gentamicin), potential alternative drugs (chloramphenicol, doxycycline, ciprofloxacin, erythromycin, rifampicin) and a newer antibiotic (quinupristin/dalfopristin).
Results : 100% (5/5) of vanB VR-E. faecium were resistant to ampicillin, gentamicin and ciprofloxacm, but 100% (5/5) were susceptible to chloramphenicol, doxycycime, teicoplanin and quinupristin/dalfopristm. 100% (11/11) of vanA VR-E. faecium were resistant to ampicillin, ciprofloxacm, 73% were resistant to gentamicin, and 100% (11/11) were susceptible to chloramphenicol and doxycycline. Quinupristin/dalfopristm showed intermediate or high level susceptibility against all vanA VRE isolates. Rifampin is less susceptible (MIC: 4-16 ㎍/mL) against both vanA and vanB VR-E. faecium.
Conclusion : The treatment options for infections caused by VRE seem to be very narrow since a small percentage of those isolates were susceptible to the other antimicrobial agents commonly used to treat these infections. And only a few of the alternative drugs including quinupristin/dalfopristin tested showed good in vitro activity. This study suggested that chloramphenicol, doxycycline and qumuprisitin/dalfopristin would be a good candidate to treat VRE infection, but further studies are necessary to demonstrate the clinical role of these antimicrobial agents.
|
|
|
Keywords : VRE, Antimicrobial susceptibility, Quinupristin/dalfopristin |
|
|
|
|
|
|
|
|
