title: Activity of vancomycin, ciprofloxacin, daptomycin, and linezolid against coagulase-negative staphylococci bacteremia.
abstract: OBJECTIVE
  Multiresistant coagulase-negative staphylococci (CNS) infections are mainly increased in hospitalized patients. We have studied the activity of vancomycin, ciprofloxacin, daptomycin and linezolid in methicillin-resistant CNS strains, isolated from true blood cultures.
  
  
  METHODS
  We collected 87 strains of different CNS species from positive blood cultures. Staphylococci were identified by MicroScan Walkaway (Dade Behring, Siemens) and with the Api ID 32 Staph (BioMerieux, France). The susceptibility to oxacillin, vancomycin and ciprofloxacin was performed by automatic microdilution plate as cited above. The susceptibility to daptomycin and linezolid was performed by Etest (AB BioMerieux, Solna, Sweden). Interpretative criteria were done following the CLSI guidelines.
  
  
  RESULTS
  Eighty-seven CNS strains were studied: 55 (63%) were S. epidermidis, 15 (17%) S. haemolyticus, 10 (12%) S. hominis, and 7 (8%) other species. Fifty-three (61%) strains showed loss of susceptibility to vancomycin, MIC = 2 mg/L. Ciprofloxacin resistance, MIC > 2 mg/L, was observed in 56 (64%) strains. Daptomycin resistance was not observed, with a susceptibility range between 0.032-1 mg/L and modal value of 0.25 mg/L. Ten strains (11.5%) resistant to linezolid were observed. Nine patients were in ICU, where the average length of stay was 38 days (range 16-58 days) and one belonged to Hepato-Pancreatic Surgery, where he stayed for 64 days.
  
  
  CONCLUSIONS
  Low susceptibility to vancomycin is frequent in the CNS strains studied in our hospital. Daptomycin shows a high efficacy against CNS, and it could be useful for the treatment of primary bacteremia or catheter associated bacteremia. The massive and continuous use of linezolid has led to the appearance of resistance.
authors.affiliation: Department of Microbiology, Infanta Cristina Universitary Hospital, Avda de Elvas sn, 06010 Badajoz, Spain. mfolivares@eresmas.com
authors.forename: Miguel
authors.initials: M
authors.lastname: Fajardo Olivares
authors.forename: Rocío
authors.initials: R
authors.lastname: Hidalgo Orozco
authors.forename: Saray
authors.initials: S
authors.lastname: Rodríguez Garrido
authors.forename: Francisco Félix
authors.initials: FF
authors.lastname: Rodríguez-Vidigal
authors.forename: Araceli
authors.initials: A
authors.lastname: Vera Tomé
authors.forename: Manuel
authors.initials: M
authors.lastname: Robles Marcos
mesh_terms: D000081:Acetamides / Q000494:pharmacology*; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000382:microbiology; D002939:Ciprofloxacin / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology; D017576:Daptomycin / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D006748:Hospital Departments; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D000069349:Linezolid; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D023303:Oxazolidinones / Q000494:pharmacology*; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000302:isolation & purification; D041162:Staphylococcus haemolyticus / Q000187:drug effects* / Q000302:isolation & purification; D041181:Staphylococcus hominis / Q000187:drug effects* / Q000302:isolation & purification; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D000081:Acetamides; D023303:Oxazolidinones; D002939:Ciprofloxacin; D014640:Vancomycin; D000069349:Linezolid; D017576:Daptomycin