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PMID: 8239604 Published · ppublish English Journal Article

Novel antibiotic regimens against Enterococcus faecium resistant to ampicillin, vancomycin, and gentamicin.

Antimicrobial agents and chemotherapy ·Vol. 37 ·No. 9 ·1993-09-00 ·Pages 1904-8

Landman D, Mobarakai NK, Quale JM

Abstract

Enterococci have emerged as significant nosocomial pathogens. Enterococci with resistance to commonly used antibiotics are appearing more frequently. We encountered at our institution several infections caused by Enterococcus faecium with high-level resistance to ampicillin, vancomycin, and gentamicin. The optimal antibiotic therapy for serious infections with unusually resistant enterococci has not been established. Using time-kill studies, we tested the effectiveness of various antibiotic combinations against 15 isolates of multidrug-resistant enterococci. No antibiotic was consistently effective when used alone. The combination of ampicillin plus ciprofloxacin was bactericidal for the 12 isolates for which the ciprofloxacin MIC was < or = 8 micrograms/ml. The combination of ciprofloxacin plus novobiocin also demonstrated activity against these isolates. No combination was found to be bactericidal for the remaining three isolates, which were highly ciprofloxacin resistant. These antibiotic combinations may be important for the future treatment of serious infections caused by these resistant pathogens.

MeSH Terms
Ampicillin Resistance Anti-Bacterial Agents/pharmacology Drug Resistance, Microbial Drug Therapy, Combination/pharmacology Enterococcus faecium/drug effects Gentamicins/pharmacology Gram-Positive Bacterial Infections/microbiology Humans Microbial Sensitivity Tests Vancomycin/pharmacology
Chemicals
Anti-Bacterial Agents Gentamicins Vancomycin
Authors & Affiliations
3 authors, click to expand affiliations / ORCID
Landman D
Department of Medicine, Department of Veterans Affairs Medical Center, Brooklyn, New York 11209.
Mobarakai N K
Quale J M
References (24)
24 references, click to expand
  1. High-level resistance to gentamicin in clinical isolates of enterococci.
    J Infect Dis. 1983 Apr;147(4):751-7 PMID: 6404994
  2. In vivo development of teicoplanin resistance in a VanB Enterococcus faecium isolate.
    J Infect Dis. 1993 May;167(5):1224-7 PMID: 8486959
  3. In vitro and in vivo activity of ciprofloxacin against enterococci isolated from patients with infective endocarditis.
    Antimicrob Agents Chemother. 1987 Mar;31(3):430-3 PMID: 3579260
  4. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium.
    N Engl J Med. 1988 Jul 21;319(3):157-61 PMID: 2968517
  5. The response of Streptococcus faecalis to ciprofloxacin, norfloxacin and enoxacin.
    J Antimicrob Chemother. 1988 May;21(5):545-54 PMID: 3134318
  6. Serious infection due to beta-lactamase-producing Streptococcus faecalis with high-level resistance to gentamicin.
    J Infect Dis. 1988 Nov;158(5):1144-5 PMID: 3141522
  7. Inducible, transferable resistance to vancomycin in Enterococcus faecalis A256.
    Antimicrob Agents Chemother. 1989 Feb;33(2):198-203 PMID: 2497704
  8. Identification of Enterococcus species isolated from human infections by a conventional test scheme.
    J Clin Microbiol. 1989 Apr;27(4):731-4 PMID: 2656745
  9. Inducible resistance to vancomycin in Enterococcus faecium D366.
    J Infect Dis. 1989 Jun;159(6):1095-104 PMID: 2723455
  10. In vitro susceptibility studies of vancomycin-resistant Enterococcus faecalis.
    Antimicrob Agents Chemother. 1989 Sep;33(9):1588-91 PMID: 2554802
  11. High-level gentamicin resistance in Enterococcus: microbiology, genetic basis, and epidemiology.
    Rev Infect Dis. 1990 Jul-Aug;12(4):644-52 PMID: 2117300
  12. Rapid dissemination of beta-lactamase-producing, aminoglycoside-resistant Enterococcus faecalis among patients and staff on an infant-toddler surgical ward.
    N Engl J Med. 1990 Dec 27;323(26):1814-8 PMID: 2123301
  13. Evidence for clonal spread of a single strain of beta-lactamase-producing Enterococcus (Streptococcus) faecalis to six hospitals in five states.
    J Infect Dis. 1991 Apr;163(4):780-5 PMID: 1901330
  14. Screening and treatment of infections caused by resistant enterococci.
    Antimicrob Agents Chemother. 1991 Feb;35(2):215-9 PMID: 2024952
  15. Major trends in the microbial etiology of nosocomial infection.
    Am J Med. 1991 Sep 16;91(3B):72S-75S PMID: 1928195
  16. Increasing resistance to beta-lactam antibiotics among clinical isolates of Enterococcus faecium: a 22-year review at one institution.
    Antimicrob Agents Chemother. 1991 Nov;35(11):2180-4 PMID: 1803989
  17. Concomitant high-level vancomycin and penicillin resistance in clinical isolates of enterococci.
    Clin Infect Dis. 1992 Mar;14(3):655-61 PMID: 1562656
  18. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers.
    Ann Intern Med. 1992 Jul 15;117(2):112-6 PMID: 1605425
  19. Emergence and nosocomial transmission of ampicillin-resistant enterococci.
    Antimicrob Agents Chemother. 1992 May;36(5):1032-9 PMID: 1510390
  20. Inconsistent bactericidal activity of triple-combination therapy with vancomycin, ampicillin, and gentamicin against vancomycin-resistant, highly ampicillin-resistant Enterococcus faecium.
    Antimicrob Agents Chemother. 1992 Jul;36(7):1563-6 PMID: 1510455
  21. Absence of synergistic activity between ampicillin and vancomycin against highly vancomycin-resistant enterococci.
    Antimicrob Agents Chemother. 1992 Oct;36(10):2201-3 PMID: 1444300
  22. Increasing resistance of enterococci to ciprofloxacin.
    Antimicrob Agents Chemother. 1992 Nov;36(11):2533-5 PMID: 1489199
  23. The vanB gene confers various levels of self-transferable resistance to vancomycin in enterococci.
    J Infect Dis. 1993 May;167(5):1220-3 PMID: 8486958
  24. In vitro activity of ciprofloxacin combined with azlocillin.
    Antimicrob Agents Chemother. 1985 Dec;28(6):849-50 PMID: 2935078
Article Info
Journal
Antimicrobial agents and chemotherapy
Abbr.
Antimicrob Agents Chemother
ISSN
0066-4804
DOI
10.1128/AAC.37.9.1904
Published
1993-09-00
Pages
1904-8
Language
English
Region
United States
NLM ID
0315061
PMCID
PMC188090
Subset
IM
External Links
PubMed source DOI: 10.1128/AAC.37.9.1904 PMC Full Text View journal details
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