title: Prevalence of macrolide-lincosamide resistance and multidrug resistance phenotypes in streptococcal isolates causing infections in European hospitals: Evaluation of the in vitro activity of oritavancin and comparator agents.
abstract: The aim of this study was to evaluate the prevalence of resistance to erythromycin alone (M) and to erythromycin and clindamycin (cMLSB) as well as multidrug resistance (MDR) phenotypes (resistance to at least three classes of drugs) among clinical enterococci from European countries and adjacent geographic regions. The in vitro activity of oritavancin against these isolates was also evaluated. A total of 2569 streptococci collected from 12 European countries as well as Russia, Turkey and Israel were included. A total of 9.8%, 8.1% and 6.4% of β-haemolytic streptococci (BHS) displayed M, cMLSBand MDR phenotypes, respectively. Oritavancin (99.4-100.0% susceptible) demonstrated modal minimum inhibitory concentration (MIC) (0.03mg/L) and MIC50(0.03mg/L) values that were the same for all BHS or subsets, including MDR. The oritavancin MIC50value of 0.06mg/L against Streptococcus dysgalactiae was similar to those of daptomycin and penicillin (MIC50≤0.06mg/L for both). Among viridans group streptococci (VGS), 28.3%, 12.7% and 11.6% showed M, cMLSBand MDR phenotypes, respectively. Oritavancin (99.9-100.0% susceptible; MIC50/90, ≤0.008/0.06mg/L) exhibited potent in vitro activity against VGS and resistant subsets, as did vancomycin (MIC50/90, 0.5/0.5-1mg/L), daptomycin (MIC50/90, 0.25-0.5/0.5-1mg/L) and linezolid (MIC50/90, 0.5-1/1mg/L). In conclusion, rates of resistance phenotypes were higher in VGS than BHS. Oritavancin demonstrated in vitro potencies that were similar to or greater than those of comparators against this recent collection of streptococci, including drug-resistant subsets, from European and adjacent countries.
authors.affiliation: JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA. Electronic address: rodrigo-mendes@jmilabs.com.
authors.forename: Rodrigo E
authors.initials: RE
authors.lastname: Mendes
authors.affiliation: JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
authors.forename: Mariana
authors.initials: M
authors.lastname: Castanheira
authors.affiliation: JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrell
authors.affiliation: JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Flamm
authors.affiliation: JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
authors.forename: Helio S
authors.initials: HS
authors.lastname: Sader
authors.affiliation: JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology; D017576:Daptomycin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D016983:Enterococcus / Q000187:drug effects; D005060:Europe / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D007557:Israel; D055231:Lincosamides / Q000494:pharmacology*; D000069349:Linezolid / Q000494:pharmacology; D000077427:Lipoglycopeptides / Q000494:pharmacology*; D018942:Macrolides / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology; D010641:Phenotype; D015995:Prevalence; D012426:Russia; D013203:Staphylococcal Infections / Q000382:microbiology; D013291:Streptococcus / Q000187:drug effects* / Q000302:isolation & purification / Q000472:pathogenicity*; D014421:Turkey; D014640:Vancomycin / Q000494:pharmacology / Q000031:analogs & derivatives; D034363:Viridans Streptococci / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D055231:Lincosamides; D000077427:Lipoglycopeptides; D018942:Macrolides; D010406:Penicillins; D014640:Vancomycin; D000069349:Linezolid; D017576:Daptomycin; C100708:oritavancin
keywords: ABSSSI; Acute bacterial skin and skin-structure infection; Bactericidal; Lipoglycopeptide